BOLTON BROOK MANOR (NPI# 1497364442) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497364442 |
| Entity Type | Organization |
| Organization Name | BOLTON BROOK MANOR |
| Practice Address |
4554 Thomas Rd Metamora MI 48455-9220 |
| Practice Telephone | 8106782087 |
| Practice Fax Number | 8106782766 |
| Mailing Telephone | 8106782087 |
| Mailing Fax Number | 8106782766 |
| Enumeration Date | 2020-07-27 |
| Last Update Date | 2020-07-27 |
| Authorized Official Name | MR. SUNIL R BHATTAD (ADMINISTRATOR) |
| Authorized Official Telephone | 2487978519 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
Nursing & Custodial Care Facilities | ||
| Y | 3104A0625X |
Assisted Living Facility Specialization: Assisted Living, Mental Illness |
Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Caremore of Metamora | Doing Business As Name - Organization |
| Street Address |
4554 THOMAS RD |
| City | METAMORA |
| State | MI |
| Zip Code | 48455-9220 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205490745 | Lydia Schwerin | Technician, Other | 5316 Thomas Rd, Metamora, MI 48455 | 2019-04-30 |
| 1518329838 | Lauren Elsner | Social Worker | 1080 Invitational Drive, Metamora, MI 48455 | 2016-03-25 |
| 1699081281 | Katie L Mysen | Nurse Practitioner | 1371 Masters Dr, Metamora, MI 48455 | 2010-08-20 |
| 1093955866 | Sandra Hembree | Nurse Practitioner | 3159 Autumn View Lane, Metamora, MI 48455 | 2009-03-05 |
| 1124176599 | Christine Rene Muzychka | Dentist | 4053 S.lapeer Rd, Suite B, Metamora, MI 48455 | 2007-01-08 |
| 1508808072 | Roger Curtis Gietzen | Psychiatry & Neurology | 3630-b Thornville Rd., Metamora, MI 48455 | 2006-06-11 |
| 1508961590 | Ammar El Nachef | Psychiatry & Neurology | 4053 S Lapeer Rd, Suite D, Metamora, MI 48455 | 2006-09-14 |
| 1750876173 | Mobicare, LLC | Nurse Practitioner | 1371 Masters Dr, Metamora, MI 48455-8701 | 2018-06-27 |
| 1306443486 | Pyles Family Dentistry Pllc | Clinic/Center | 4053 S Lapeer Rd Ste B, Metamora, MI 48455-8718 | 2020-10-02 |
| 1497798326 | Heidi R Irwin | Physical Therapist | 4053 S Lapeer Rd, Ste C, Metamora, MI 48455-8721 | 2006-06-14 |
| Find all providers in zip 48455 | ||||
| Taxonomy Code | 3104A0625X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| Specialization | Assisted Living, Mental Illness |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154947703 | Bay City Comfort Care | Assisted Living Facility | 4130 Shrestha Dr, Bay City, MI 48706-2184 | 2020-06-19 |
| 1548807142 | Mother of Grace LLC | Assisted Living Facility | 7947 Tulane St, Taylor, MI 48180-2321 | 2019-12-03 |
| 1881231629 | Better Life Residential Care Inc | Assisted Living Facility | 4444 Lincoln Blvd, Dearborn Hts, MI 48125-2568 | 2019-11-27 |
| 1700433042 | Golden Life Afc LLC | Assisted Living Facility | 10710 Roy Dr, Greenville, MI 48838-9105 | 2019-08-21 |
| 1225513468 | Harmony Hearts Village LLC | Assisted Living Facility | 7773 Sherwood St, Detroit, MI 48211-1785 | 2018-10-03 |
| 1699277004 | Leann Renee Gastelum | Assisted Living Facility | 19301 Winthrop St, Detroit, MI 48235 | 2018-03-01 |
| 1245769991 | Mecca House Corporation | Assisted Living Facility | 53 West Huron, Pontiac, MI 48342 | 2017-06-07 |
| 1225564768 | Country Haven | Assisted Living Facility | 413 E Muskegon St, Cedar Springs, MI 49319-9596 | 2017-05-03 |
| 1205382389 | B&r Holistic Care Housing, LLC | Assisted Living Facility | 19303 Mark Twain St, Detroit, MI 48235-1914 | 2016-08-29 |
| 1841683158 | Hill's Support Services Inc. | Assisted Living Facility | 6430 Washington St, Romulus, MI 48174-1742 | 2015-03-11 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.