GREEN LAKE OPCO, LLC


Address: 6470 Alden Dr, West Bloomfield, MI 48324-2006
Phone: 2483634121

GREEN LAKE OPCO, LLC (NPI# 1881074961) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1881074961
Entity Type Organization
Organization Name GREEN LAKE OPCO, LLC
Other Organization Name THE VILLA AT GREEN LAKE ESTATES
Practice Address 6470 Alden Dr
West Bloomfield
MI 48324-2006
Mailing Address 3755 Chase Ave
Skokie
IL 60076-4008
Practice Telephone 2483634121
Mailing Telephone 8474402660
Enumeration Date 2015-06-04
Last Update Date 2016-03-07
Authorized Official Name BEN ISREAL (CEO)
Authorized Official Telephone 8474402660
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 314000000X Skilled Nursing Facility Nursing & Custodial Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
MI 1881074961 05

Other Provider/Organization Names

Other Name Type Code
The Villa at Green Lake Estates Doing Business As Name - Organization

Office Location

Street Address 6470 ALDEN DR
City WEST BLOOMFIELD
State MI
Zip Code 48324-2006

Providers in the same location

NPI Name Taxonomy Address Enumeration
1144721861 Virginia Pepito Benedict Physical Therapist 6470 Alden Dr, West Bloomfield, MI 48324-2006 2018-02-27

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NPI Name Taxonomy Address Enumeration
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1700308632 Jennifer Dulchavsky Counselor 3538 Winterberry, West Bloomfield, MI 48324 2017-07-12
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1538495551 Joseph S. Dulka Psychiatry & Neurology 3573 Elder Rd S., West Bloomfield, MI 48324 2009-10-27
1700041928 Allan Jay Levine Pathology 2268 Forest Glen Dr, West Bloomfield, MI 48324 2008-07-28
1952561706 Deepika Aggarwal Dentist 6259 Willow Ct, West Bloomfield, MI 48324 2008-06-16
1366627358 Tatyana Kuzminsky Nutritionist 2486 Island View Dr, West Bloomfield, MI 48324 2008-01-08
1053407742 Katherine Ann Young Psychologist 1943 Windside, West Bloomfield, MI 48324 2006-10-04
1629072038 Alfonso Acosta Family Medicine 7173 Ilanaway Dr, West Bloomfield, MI 48324 2005-06-13
1942441142 Patricia L Denham Social Worker 1916 Henbert Rd, West Bloomfield, MI 48324-1036 2009-03-18
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Taxonomy Information

Taxonomy Code 314000000X
Grouping Nursing & Custodial Care Facilities
Classification Skilled Nursing Facility

Taxonomy Definition

(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey.

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NPI Name Taxonomy Address Enumeration
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1851330732 Health Care and Retirement Corporation of America LLC Skilled Nursing Facility 6800 W Maple Rd, West Bloomfield, MI 48322-2792 2006-06-06
1699772087 Bloomfield Orchard Acquisition Company, Inc Skilled Nursing Facility 7277 Richardson Rd, West Bloomfield, MI 48323-1266 2005-06-30
1073518171 West Bloomfield Health and Rehabilitation Center, LLC Skilled Nursing Facility 6445 W Maple Rd, West Bloomfield, MI 48322-2047 2005-06-15
1255820890 West Bloomfield Snf, LLC Skilled Nursing Facility 6950 Farmington Rd, West Bloomfield, MI 48322-3220 2018-05-09
1669808622 Maple-drake Real Estate, LLC Skilled Nursing Facility 6535 Drake Rd, West Bloomfield, MI 48322-3147 2013-09-23

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1336795244 Ishpeming Nursing & Rehab Center, LLC Skilled Nursing Facility 435 Rd Pl, Ishpeming, MI 49849 2019-08-15
1669965299 Wellbridge of Clarkston, LLC Skilled Nursing Facility 5655 Clarkston Road, Independence Township, MI 48348 2018-06-08
1104318112 Wellbridge At Genesys Health Park, LLC Skilled Nursing Facility 3139 East Baldwin Road, Grand Blanc, MI 48439 2018-06-05
1427549955 Mission Point of Detroit, LLC Skilled Nursing Facility 2102 Orleans, Detroit, MI 48207 2018-05-21
1912496324 Regency At Independence Township, LLC Skilled Nursing Facility 6211 Stonewood Drive, Clarkston, MI 48346 2018-05-02
1972092344 Regency At Grand Haven, LLC Skilled Nursing Facility 17049 Comstock St, Grand Haven, MI 49417-7903 2018-05-01
1093214173 Sana Nasir Inc. Skilled Nursing Facility 13840 King Rd, Riverview, MI 48193 2018-02-05
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Competitor

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City WEST BLOOMFIELD
Zip Code 48324

Improve Information

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Dataset Information

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.

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