OrganizationActive
Lake Shore Afc, LLC
NPI 1669968129 · Assisted Living Facility (Behavioral Disturbances) · Grawn, MI
Provider details
- NPI number
- 1669968129
- Entity type
- Organization
- Primary specialty
- Assisted Living Facility (Behavioral Disturbances)Nursing & Custodial Care Facilities
- Authorized official
- Randy Scholtus, Administrator
- License
- AM280289926 (MI)
Practice location
2480 Tonawanda Lake Rd
Grawn, MI 49637-9615
Phone: (231) 276-9260
Fax: (231) 276-9380
Mailing address
Po Box 119
Grawn, MI 49637-0119
Registry dates
- Enumerated
- 2018-07-09
- Last updated
- 2018-07-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.