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LAKE SHORE AFC, LLC
NPI 1669968129
Assisted Living Facility - Assisted Living, Behavioral Disturbances in Grawn, MI

Active since July 09, 2018
2480 TONAWANDA LAKE RD, GRAWN, MI 49637(231) 276-9260(231) 276-9380 Get Directions Write a Review

NPPES record last updated: July 9, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Lake Shore Afc, Llc NPPES

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

LAKE SHORE AFC, LLC (NPI 1669968129) is a healthcare organization registered as an assisted living, behavioral disturbances in Grawn, Michigan and active in the NPI registry since July 2018. The organization lists Randy John Scholtus, Administrator, as its authorized official.

NPPES Registry Identity

NPI1669968129
Entity TypeOrganization
Primary Taxonomy3104A0630X
Legal Business NameLAKE SHORE AFC, LLC
Location Address2480 TONAWANDA LAKE RDGrawn, MI 49637-9615
Mailing AddressPo Box 119Grawn, MI 49637-0119 · (231) 276-9260 · Fax (231) 276-9380
Phone(231) 276-9260
Fax(231) 276-9380
Organization SubpartNo
Authorized OfficialRandy John ScholtusAdministrator · (231) 276-9260
Enumeration DateJuly 9, 2018
✔ NPI 1669968129 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living Facility · Assisted Living, Behavioral DisturbancesNursing & Custodial Care Facilities
Taxonomy Code3104A0630X
License✔ Licensed in MI · AM280289926
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but exhibit abnormal behavioral responses and habits and therefore need special guidance, assistance and/or monitoring to assure safety and well being. This type of facility requires a staff with special training in dealing with and redirecting negative, violent or destructive behaviors.
2480 TONAWANDA LAKE RD, Grawn, MI 49637
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Other Names 1

Doing Business AsLake Shore Afc, Llc

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 Lake Shore AFC, LLC's NPI number?

The NPI number for Lake Shore AFC, LLC is 1669968129. It was assigned to this organization in the NPPES registry on July 9, 2018.

Where is Lake Shore AFC, LLC located?

Lake Shore AFC, LLC is located at 2480 Tonawanda Lake Rd, Grawn, MI 49637. The listed phone number is (231) 276-9260.

What is Lake Shore AFC, LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility, specializing in Assisted Living, Behavioral Disturbances, with taxonomy code 3104A0630X.

When was this NPI record last updated?

The NPPES record for Lake Shore AFC, LLC was last updated on July 9, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.