Lutheran Homes of Michigan, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

824200 Issued in MI

Legal business name

LUTHERAN HOMES OF MICHIGAN, INC.

Doing business as

Lutheran Home-Livonia

Practice address

28910 Plymouth Rd
Livonia, MI 48150-2337

Phone

(734) 425-4814

Fax

(734) 425-6024

NPI assigned

Jun 10, 2005

Last updated

Sep 11, 2007By the provider in NPPES

Organization subpart

Yes

Parent organization

LUTHERAN HOMES OF MICHIGAN, INCAs reported in NPPES

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

Authorized official

Name

Mr. Michael G Corby

Title

Controller

Phone

(989) 652-3470

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Lutheran Home-Livonia Doing business as

Part of

Lutheran Home Care Agency Inc

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

{
    "created_epoch": "1118361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189468800000",
    "number": "1932103678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9710 JUNCTION RD",
            "address_2": "P.O. BOX 329",
            "city": "FRANKENMUTH",
            "state": "MI",
            "postal_code": "487340329",
            "telephone_number": "989-652-3470",
            "fax_number": "989-652-3480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28910 PLYMOUTH RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481502337",
            "telephone_number": "734-425-4814",
            "fax_number": "734-425-6024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUTHERAN HOMES OF MICHIGAN, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LUTHERAN HOMES OF MICHIGAN, INC",
        "enumeration_date": "2005-06-10",
        "last_updated": "2007-09-11",
        "status": "A",
        "authorized_official_last_name": "CORBY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "989-652-3470",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MI",
            "license": "824200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS INS. PROVIDER #",
            "identifier": "S 9505",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4076769",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lutheran Home-Livonia",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Luis Pomodoro M D PC
• Charmagne Celeste Lundberg, LPC
• Jeffrey Robert Lupovitch, MD
• Shannan Lustig
• Lutheran Homes of Michigan, Inc.
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• Skilled Nursing Facility in Livonia, MI
• Providers in Livonia, MI by specialty
• Skilled Nursing Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2007; 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.