Provider Demographics
NPI:1083003453
Name:THE WELLCARE GROUP, LLC
Entity Type:Organization
Organization Name:THE WELLCARE GROUP, LLC
Other - Org Name:CHESANING NURSING AND REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:AMEE
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-834-7377
Mailing Address - Street 1:46036 MICHIGAN AVE
Mailing Address - Street 2:SUITE 108
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48188-2304
Mailing Address - Country:US
Mailing Address - Phone:734-834-7377
Mailing Address - Fax:
Practice Address - Street 1:201 S FRONT ST
Practice Address - Street 2:
Practice Address - City:CHESANING
Practice Address - State:MI
Practice Address - Zip Code:48616-1328
Practice Address - Country:US
Practice Address - Phone:989-845-6602
Practice Address - Fax:989-845-4719
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-22
Last Update Date:2015-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
235641Medicare Oscar/Certification