Lake Shore Afc, LLC
Organization Active NPI Assisted Living Facility (Behavioral Disturbances) · Grawn, MI
NPI 1669968129 · NPPES record last updated Jul 9, 2018
Key facts
- NPI
- 1669968129
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Assisted Living Facility (Behavioral Disturbances) 3104A0630X
- License
- AM280289926 (MI)
- Legal business name
- LAKE SHORE AFC, LLC
- Practice address
- 2480 Tonawanda Lake Rd
Grawn, MI 49637-9615 - Phone
- (231) 276-9260
- Fax
- (231) 276-9380
- NPI assigned
- Jul 9, 2018
- Organization subpart
- No
Authorized official
- Name
- Mr. Randy John Scholtus
- Title
- Administrator
- Phone
- (231) 276-9260
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility (Behavioral Disturbances) | 3104A0630X | AM280289926 | MI | Yes |
Addresses
Primary practice location
2480 Tonawanda Lake Rd
Grawn, MI 49637-9615
Mailing address
PO Box 119
Grawn, MI 49637-0119
Phone (231) 276-9260
Other names
- Lake Shore AFC, LLC
Other providers in Grawn, MI
- Rebekah Anderson
- Cutting Edge Eyewear
- Great Lakes Medical Transport
- Health at Its Best, PLLC
- Sarah Jean Hehir
- Kevin Pickard
- Leah Preston
- Quinn Rycenga
- Ashley Curtis Tarras
- Township of Blair
All providers in Grawn, MI · Assisted Living Facility (Behavioral Disturbances) in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.