NPIMap

Organization Active NPI

Boulevard Temple Care Center, LLC

  • Skilled Nursing Facility
  • Detroit, MI
National Provider Identifier
1689805970
Registry record updated Sep 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
BOULEVARD TEMPLE CARE CENTER, LLC
Practice address
2567 W Grand Blvd
Detroit, MI 48208-1235
Phone
(313) 895-5340
Fax
(313) 895-5970
NPI assigned
Aug 4, 2009
Last updated
Sep 16, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
CIENA HEALTHCARE MANAGEMENT, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 16, 2026

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

Authorized official

Name
Mr. Mohammad A Qazi
Title
Ceo/President
Phone
(248) 386-0300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

2567 W Grand Blvd
Detroit, MI 48208-1235

Mailing address

2567 W Grand Blvd
Detroit, MI 48208-1235
Phone (313) 895-5340

Other identifiers 1

IdentifierTypeStateIssuer
2153377MedicaidMI

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100127000437 MI Part A Provider - Skilled Nursing Facility 6305991779 Practice locations: Detroit, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1689805970. Details of each certification follow.

Skilled nursing facility certification: CCN 235498

Legal name
BOULEVARD TEMPLE CARE CENTER, LLC
Doing business as
BOULEVARD TEMPLE CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
May 3, 1990
Last certification
May 14, 2025
Beds
124
Ownership / control type
Individual
Multi-facility organization
Ciena Healthcare
Most recent change of ownership
Dec 1, 2009
Organization structure
LLCProprietary
Incorporated
May 11, 2009 in MI
Enrollment address
2567 W Grand Blvd
Detroit, MI 48208-1235
Nursing home name
BOULEVARD TEMPLE CARE CENTER, LLC
Affiliated entity
CIENA HEALTHCARE/LAUREL HEALTH CARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Boulevard Temple Care Center, LLCCCN 235498 · All quality measures
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
4 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Individual
Certified
May 3, 1990
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
124118.1 residents per day on average
Chain
Ciena Healthcare/Laurel Health Care81 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 13

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Ciena Healthcare Management Inc Organization, Southfield, MI Corporation, Management services company, For-profit, Chain home office Operational/Managerial Control Dec 1, 2009
Adp of the SNF Mar 19, 2025
Carney Bradford Individual Operational/Managerial Control Aug 29, 2023
Adp of the SNF Aug 29, 2023
Individual Adp of the SNF Jan 17, 2022
Flora Ann Dean Individual Operational/Managerial Control Jan 1, 2025
Adp of the SNF Jan 1, 2025
Individual Adp of the SNF Dec 1, 2009
Anis Khan Individual Operational/Managerial Control Dec 1, 2009
Managing Control - Governing BodyManager Dec 1, 2009
Adp of the SNF Dec 1, 2009
Mohammad a. Qazi Individual 5% Or Greater Indirect Ownership InterestManager Dec 1, 1999 100%
Operational/Managerial Control Dec 1, 2009
Managing Control - Governing BodyManager Dec 1, 2009
Adp of the SNF Dec 1, 2009
Mohammad a Qazi Living Trust Dated 09/26/97 Organization, West Bloomfield, MI For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Dec 1, 2009 100%
Adp of the SNF Dec 1, 2009
Organization, Taylor, MI LLC, For-profit Adp of the SNF Mar 19, 2025
Individual Adp of the SNF Mar 1, 2022
Organization, Glenview, IL LLC, For-profit Adp of the SNF Mar 19, 2025
Individual Adp of the SNF Dec 1, 2024
Organization, Southfield, MI LLC, For-profit Adp of the SNF Dec 1, 2009

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 76

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 76

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1249344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789516800000",
    "number": "1689805970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2567 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482081235",
            "telephone_number": "313-895-5340",
            "fax_number": "313-895-5970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2567 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482081235",
            "telephone_number": "313-895-5340",
            "fax_number": "313-895-5970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOULEVARD TEMPLE CARE CENTER, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CIENA HEALTHCARE MANAGEMENT, INC",
        "enumeration_date": "2009-08-04",
        "last_updated": "2026-09-16",
        "certification_date": "2026-09-16",
        "status": "A",
        "authorized_official_last_name": "QAZI",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "248-386-0300",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2153377",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "affiliationName": "Ability Network Inc",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD Emdr",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd SteB",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.