LOURDES ASSISTED LIVING NPI 1013446459

NPI Information

NPI: 1013446459
Provider Name: LOURDES ASSISTED LIVING
Classification: Assisted Living Facility - 310400000X
Entity Type: Organization
Doing Business As: MENDELSON HOME
CLIA Number: 23D2075798
Address: 2450 WATKINS LAKE RD
WATERFORD, MI
ZIP 48328
Phone: (248) 618-6362

Map and Directions

Get Directions

NPI Details

LOURDES ASSISTED LIVING is an assisted living facility in Waterford, MI. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. LOURDES ASSISTED LIVING NPI is 1013446459. The provider is registered as an organization entity type.
The provider Is Doing Business As Mendelson Home.

The provider's business location address is:

2450 WATKINS LAKE RD
WATERFORD, MI
ZIP 48328
Phone: (248) 618-6362
Fax: (248) 618-6361

The provider's authorized official is Cori Sharrard .
The authorized official title is Director and has the following contact phone number (248) 886-5102.

The CLIA number assigned to this NPI record is 23D2075798 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/8/2017 and was last updated on 7/21/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	310400000X	Assisted Living Facility		AH630236917	MICHIGAN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	AH630236917	OTHER	MICHIGAN	HOME FOR THE AGED

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI

Next NPI