Provider Demographics
NPI:1417983685
Name:BOTSFORD CONTINUING HEALTH CENTER
Entity Type:Organization
Organization Name:BOTSFORD CONTINUING HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:K
Authorized Official - Last Name:LIGHTNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-426-6950
Mailing Address - Street 1:26901 BEAUMONT BLVD.
Mailing Address - Street 2:COMPLIANCE
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-4716
Mailing Address - Country:US
Mailing Address - Phone:947-522-1963
Mailing Address - Fax:
Practice Address - Street 1:21450 ARCHWOOD CIR
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48336-4127
Practice Address - Country:US
Practice Address - Phone:248-477-7400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-22
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI634470251E00000X, 310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI66202AOtherHEALTH ALLIANCE PLAN
MI1570034 TYPE 60Medicaid
MI09690OtherBLUE CROSS BLUE SHIELD
MISN630004OtherMCARE