BERRY ADULT FOSTER CARE HOMES INC (NPI# 1023310588) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023310588 |
| Entity Type | Organization |
| Organization Name | BERRY ADULT FOSTER CARE HOMES INC |
| Other Organization Name | ONE ON ONE RESPITE CARE |
| Practice Address |
3640 Mcdougall St Detroit MI 48207-2344 |
| Practice Telephone | 3135791881 |
| Mailing Telephone | 3135791881 |
| Enumeration Date | 2010-12-03 |
| Last Update Date | 2010-12-03 |
| Authorized Official Name | MRS. ELVA DENISE STEWARD-CARSON (OWNER/CEO/PRESIDENT) |
| Authorized Official Telephone | 3135791881 |
| Authorized Official Credential | RN MBA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 311Z00000X | Custodial Care Facility | AM820010100 | MI | Nursing & Custodial Care Facilities |
| N | 320700000X | Residential Treatment Facility, Physical Disabilities | AM820010100 | MI | Residential Treatment Facilities |
| N | 320800000X | Community Based Residential Treatment Facility, Mental Illness | AM820010100 | MI | Residential Treatment Facilities |
| N | 385H00000X | Respite Care | AM820010100 | MI | Respite Care Facility |
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
AM820010100 | MI | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| One on One Respite Care | Doing Business As Name - Organization |
| Street Address |
3640 MCDOUGALL ST |
| City | DETROIT |
| State | MI |
| Zip Code | 48207-2344 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245848506 | Anton R Gonzales | Physical Therapy Assistant | 2295 Chene, Detroit, Mi 48207, Detroit, MI 48207 | 2020-07-22 |
| 1033733928 | Taleshia Moss | Occupational Therapist | 2295 Chene, Detroit, MI 48207 | 2020-06-05 |
| 1942858550 | Ronald Royce Cochran | Counselor | 2925 Russell St, Detroit, Detroit, MI 48207 | 2019-08-27 |
| 1649831439 | Charday Penick | Social Worker | Team Wellness, 2925 Russell St, Detroit, MI 48207 | 2019-06-24 |
| 1568023349 | Alphia Ramona Burgess | Social Worker | Team Wellness Center, 2925 Russell Street, Detroit, MI 48207 | 2019-06-24 |
| 1447741608 | Sherice Ward | Social Worker | 100 River Place Drive, Ste 250, Detroit, MI 48207 | 2018-05-23 |
| 1427549955 | Mission Point of Detroit, LLC | Skilled Nursing Facility | 2102 Orleans, Detroit, MI 48207 | 2018-05-21 |
| 1043723737 | Olivia Carter | Case Management | 2712 Gratiot, Detroit, MI 48207 | 2017-11-16 |
| 1558885590 | Kalimah Johnson | Social Worker | 701 Mcdougall, Detroit, MI 48207 | 2017-08-01 |
| 1922534692 | Angela Young | Social Worker | 100 River Place 520, Detroit, MI 48207 | 2017-05-02 |
| Find all providers in zip 48207 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| 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. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063028694 | Zcare | Custodial Care Facility | 8676 Auburn St, Detroit, MI 48228-2919 | 2020-09-18 |
| 1790397594 | St. Ruth's House of Hope LLC | Custodial Care Facility | 3100 S Electric St, Detroit, MI 48217-1133 | 2020-08-21 |
| 1558837229 | New Center Inn Company | Custodial Care Facility | 158 Pingree St, Detroit, MI 48202-2022 | 2018-10-19 |
| 1477029700 | Acon Services, Inc. | Custodial Care Facility | 17126 Prevost St, Detroit, MI 48235-3551 | 2018-10-14 |
| 1619452588 | Hudson Home 1 Inc | Custodial Care Facility | 750 Virginia Park St, Detroit, MI 48202-2033 | 2018-09-26 |
| 1578083077 | New Advantage Inc. | Custodial Care Facility | 15375 Ardmore St, Detroit, MI 48227-3222 | 2017-06-26 |
| 1003348145 | Reality Response LLC | Custodial Care Facility | 2455 W Grand St, Detroit, MI 48238-3445 | 2017-03-29 |
| 1376080614 | Crystal Serenity House | Custodial Care Facility | 14241 Faust Ave Ste 200-b, Detroit, MI 48223-3574 | 2017-01-25 |
| 1225585250 | Maan Down LLC | Custodial Care Facility | 16885 Ilene St, Detroit, MI 48221 | 2016-09-07 |
| 1881051712 | Tasha Harris | Custodial Care Facility | 6402 Penrod St, Detroit, MI 48228-4748 | 2016-01-22 |
| Find all providers in DETROIT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.