MR. TYLER MARK LY
NPI 1487182960
Custodial Care Facility - Adult Care Home in Rockford, MI

Q: What is Tyler Ly's NPI number?

The NPI number for Tyler Ly is 1487182960. It was assigned to this individual provider in the NPPES registry on May 30, 2017.

Q: What is Tyler Ly's specialty?

The primary specialty registered for this NPI is Custodial Care Facility, specializing in Adult Care Home, with taxonomy code 311ZA0620X.

Q: When was this NPI record last updated?

The NPPES record for Tyler Ly was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 30, 2017

5430 POLAR BEAR CT NE, ROCKFORD, MI 49341(616) 260-8194(616) 883-6531 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 21, 2022, May 30, 2017 (2 updates tracked since 2017).

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About Mr. Tyler Mark Ly NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. TYLER MARK LY (NPI 1487182960) is an individual adult care home provider in Rockford, Michigan, licensed in Michigan (AF410343519) and active in the NPI registry since May 2017.

NPPES Registry Identity

NPI1487182960

Entity TypeIndividualMale

Primary Taxonomy311ZA0620X

Provider Legal NameMR. TYLER MARK LY

Location Address5430 POLAR BEAR CT NERockford, MI 49341-7517

Mailing Address5430 Polar Bear Ct NeRockford, MI 49341-7517 · (616) 260-8194 · Fax (616) 883-6531

Phone(616) 260-8194

Fax(616) 883-6531

Sole ProprietorYes

Enumeration DateMay 30, 2017

Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration

✔ NPI 1487182960 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCustodial Care Facility · Adult Care HomeNursing & Custodial Care Facilities

Taxonomy Code311ZA0620X

License✔ Licensed in MI · AF410343519

Definition

A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.

5430 POLAR BEAR CT NE, Rockford, MI 49341

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tyler Ly's NPI number?

The NPI number for Tyler Ly is 1487182960. It was assigned to this individual provider in the NPPES registry on May 30, 2017.

Where is Tyler Ly located?

Tyler Ly practices at 5430 Polar Bear Ct NE, Rockford, MI 49341. The listed phone number is (616) 260-8194.

What is Tyler Ly's specialty?

The primary specialty registered for this NPI is Custodial Care Facility, specializing in Adult Care Home, with taxonomy code 311ZA0620X.

When was this NPI record last updated?

The NPPES record for Tyler Ly was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.