Provider Demographics
NPI:1659344844
Name:BURCHAM HILLS RETIREMENT CENTER II
Entity Type:Organization
Organization Name:BURCHAM HILLS RETIREMENT CENTER II
Other - Org Name:BURCHAM HILLS RETIREMENT COMMUNITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:C
Authorized Official - Last Name:KACZMARCZYK
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:517-351-4662
Mailing Address - Street 1:2700 BURCHAM DR
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-3898
Mailing Address - Country:US
Mailing Address - Phone:517-351-8377
Mailing Address - Fax:517-336-1916
Practice Address - Street 1:2700 BURCHAM DR
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-3898
Practice Address - Country:US
Practice Address - Phone:517-351-8377
Practice Address - Fax:517-336-1916
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-09
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI339030314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2587690Medicaid
MI2587690Medicaid