Provider Demographics
NPI:1225854144
Name:BYERLY ENTERPRISES II, LLC
Entity type:Organization
Organization Name:BYERLY ENTERPRISES II, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:WESLEY
Authorized Official - Last Name:BYERLY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:819-691-6400
Mailing Address - Street 1:4759 OWASCO CT
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48348-2273
Mailing Address - Country:US
Mailing Address - Phone:810-691-6400
Mailing Address - Fax:248-574-5999
Practice Address - Street 1:6490 EASTLAWN AVE
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:MI
Practice Address - Zip Code:48346-2422
Practice Address - Country:US
Practice Address - Phone:810-691-6400
Practice Address - Fax:248-574-5999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-25
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility