COUNTRY MANOR CARE CENTER (NPI# 1538595343) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538595343 |
| Entity Type | Organization |
| Organization Name | COUNTRY MANOR CARE CENTER |
| Practice Address |
11241 California Bridgman MI 49106-9731 |
| Practice Telephone | 2694655320 |
| Practice Fax Number | 2694655320 |
| Mailing Telephone | 2694655320 |
| Mailing Fax Number | 2694655320 |
| Enumeration Date | 2013-09-25 |
| Last Update Date | 2013-09-25 |
| Authorized Official Name | MRS. DEBRA MARIE RUFF (LIC. NURSE / OWNER /PARTNER) |
| Authorized Official Telephone | 2694655320 |
| Authorized Official Credential | LPN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 253J00000X | Foster Care Agency | AM110076805 | MI | Agencies |
| Street Address |
11241 CALIFORNIA |
| City | BRIDGMAN |
| State | MI |
| Zip Code | 49106-9731 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043670151 | Ruffs Care Centers | Custodial Care Facility | 11241 California, Bridgman, MI 49106-9731 | 2016-03-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992191993 | Jenil Gandhi | Internal Medicine | 9999 Red Arrow Hwy, Bridgman, MI 49106 | 2015-04-07 |
| 1356670590 | Kenneth Mays | Family Medicine | 4299 Lake Street, Bridgman, MI 49106 | 2009-12-17 |
| 1164623385 | Dockerty Health Care Services Inc | Assisted Living Facility | 8850 Red Arrow Hwy, Bridgman, MI 49106 | 2007-05-29 |
| 1528278918 | Michael Joseph Marcincuk | Dentist | Red Arrow Dentistry, 9500 Red Arrow Highway, Bridgman, MI 49106 | 2007-05-23 |
| 1356304059 | Ryan E. Thomas, D.d.s. P.C. | Dentist | 9151 Red Arrow Hwy, Bridgman, MI 49106 | 2006-04-11 |
| 1316220106 | Lynda Sparks | Pharmacist | 3681 Shawnee Rd, Rite Aid Pharmacy, Bridgman, MI 49106 | 2011-09-28 |
| 1497965040 | Bridgman Psychological Services | Psychologist | 7889 Red Arrow Hwy, Bridgman, MI 49106 | 2007-05-23 |
| 1750696191 | Latreasa Klann | Doula | 9547 Maplewood, Bridgman, MI 49106-0156 | 2010-08-10 |
| 1548487168 | Bridgman Chiropractors. P.C. | Chiropractor | 9500 Red Arrow Hwy., Bridgman, MI 49106-0326 | 2007-04-18 |
| 1578786620 | John H. Foti, P.C. | Chiropractor | 4270 Lake St., Box 489, Bridgman, MI 49106-0489 | 2007-04-10 |
| Find all providers in zip 49106 | ||||
| Taxonomy Code | 253J00000X |
| Grouping | Agencies |
| Classification | Foster Care Agency |
| A Foster Care Agency is an agency that provides foster care as defined in the Code of Federal Regulations (CFR) as "24-hour substitute care for children outside their own homes." Foster care settings include, but are not limited to, nonrelative foster family homes, relative foster homes (whether payments are being made or not), group homes, emergency shelters, residential facilities, and pre-adoptive homes. |
| Notes: Source: Code Of Federal Regulations, Title 45, Volume 4, Part 1355, Section 57 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609474576 | Maryann Michelle Lavender | Foster Care Agency | 5633 Embassy St, Kalamazoo, MI 49009-6499 | 2020-10-13 |
| 1417560269 | Fountain of Love | Foster Care Agency | 2140 Dickerson St, Detroit, MI 48215-2640 | 2020-08-30 |
| 1376165076 | Haven Adult Foster Care Ltd | Foster Care Agency | 73600 Church St, Armada, MI 48005-4749 | 2020-05-15 |
| 1104448018 | Jody Elizabeth Josephson | Foster Care Agency | 7415 Dexter Pinckney Rd, Dexter, MI 48130-7505 | 2020-05-13 |
| 1639701600 | Colonial Park Adult Assisted Living | Foster Care Agency | 1050 W Colonial Park Dr, Grand Ledge, MI 48837-2215 | 2020-02-07 |
| 1972135200 | Absolute Care LLC | Foster Care Agency | 5847 Naneva Ct, West Bloomfield, MI 48322-2517 | 2020-02-05 |
| 1699315556 | Reliance Manor LLC | Foster Care Agency | 35156 Ecorse Rd, Romulus, MI 48174-1640 | 2020-01-08 |
| 1215573217 | Byerly Enterprises, LLC | Foster Care Agency | 8616 Hidden Acre Ct, Clarkston, MI 48348-2895 | 2019-11-25 |
| 1235789553 | Dorthie Bolden | Foster Care Agency | 7027 Baseline Rd, South Haven, MI 49090-8338 | 2019-09-18 |
| 1457909509 | Sallie Mae Emert | Foster Care Agency | 2850 W Leinaar Rd, Delton, MI 49046-9567 | 2019-09-02 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on COUNTRY MANOR CARE CENTER.
| 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.