Lakeshore Care Corp

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AM610009232 Issued in MI

Legal business name

LAKESHORE CARE CORP

Practice address

8842 Cedar Creek Dr
Holton, MI 49425-8599

Phone

(231) 821-0281

Fax

(231) 821-0281

NPI assigned

Sep 23, 2013

Last updated

Sep 25, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Timothy G Adams

Title

President

Phone

(616) 813-5472

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Lakeshore Care Corp2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Lakeshore Care Corp

  • Assisted Living Facility
  • Holton, MI
  • NPI 1609202589
  NPD tax ID

Locations

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

{
    "created_epoch": "1379894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380067200000",
    "number": "1619303591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 MADISON AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034618",
            "telephone_number": "616-459-9331",
            "fax_number": "616-459-9331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8842 CEDAR CREEK DR",
            "city": "HOLTON",
            "state": "MI",
            "postal_code": "494258599",
            "telephone_number": "231-821-0281",
            "fax_number": "231-821-0281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESHORE CARE CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-23",
        "last_updated": "2013-09-25",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "616-813-5472",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MI",
            "license": "AM610009232",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3305704",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Madelyn K Eling
• Lauren Ashley Golden
• Hackley Community Care Center Inc (Holton High School)
• Hackley Community Care Center Inc (Holton Elementary School)
• Lakeshore Care Corp
• Jaylene Marsh, CTRS
• Moira Monaghan
• Kennedy Porter
• Janet Carol Smith, LMSW
• Gabriayle Stapf, CPD, CBD

• Assisted Living Facility in Holton, MI
• Providers in Holton, MI by specialty
• Assisted Living Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.