Lakeshore Senior Care LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

LAKESHORE SENIOR CARE LLC

Doing business as

Lakeshore Senior Care

Practice address

320 N 120TH Ave
Ste 230
Holland, MI 49424-2696

Phone

(616) 994-9900

NPI assigned

Jul 24, 2013

Last updated

Jul 24, 2013By the provider in NPPES

Organization subpart

Yes

Parent organization

LAKESHORE LEGACY GROUP FAMILY LIMITED PARTNERSHIPAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Scott James Bolthouse

Title

Chief Executive Officer

Phone

(616) 994-9900

Specialties & licenses 1

Addresses

Other names 1

• Lakeshore Senior Care Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1374624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374624000000",
    "number": "1568804169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 N 120TH AVE",
            "address_2": "STE 230",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494242696",
            "telephone_number": "616-994-9900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 N 120TH AVE",
            "address_2": "STE 230",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494242696",
            "telephone_number": "616-994-9900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESHORE SENIOR CARE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LAKESHORE LEGACY GROUP FAMILY LIMITED PARTNERSHIP",
        "enumeration_date": "2013-07-24",
        "last_updated": "2013-07-24",
        "status": "A",
        "authorized_official_last_name": "BOLTHOUSE",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "616-994-9900",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeshore Senior Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lakeshore Family Chiropractic, PLC
• Lakeshore Health Partners
• Lakeshore Internal Medicine and Pediatric Associates
• Lakeshore Plastic and Reconstructive Surgery Associates, P.C. (Plastic Surgery Arts of West Michigan)
• Lakeshore Psychological & Counseling Services, PC
• Lakeshore Sleep Solutions, PLLC
• Lakeshore Surgical Associates PC
• Lakeside ENT, P.C.
• Lakeside Osteopathic Manipulative Medicine PLLC
• Lakeside Therapy LLC

• Home Health Agency in Holland, MI
• Providers in Holland, MI by specialty
• Home Health Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.