MAGNOLIA CARE AFC HOME LLC (NPI# 1184191918) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184191918 |
| Entity Type | Organization |
| Organization Name | MAGNOLIA CARE AFC HOME LLC |
| Practice Address |
9200 W Walker Rd Manton MI 49663-9315 |
| Practice Telephone | 2318394585 |
| Mailing Telephone | 2318394585 |
| Enumeration Date | 2018-10-30 |
| Last Update Date | 2018-10-30 |
| Authorized Official Name | CARRIE LYNN DEXTROM (OWNER) |
| Authorized Official Telephone | 2318788352 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 253J00000X | Foster Care Agency | Agencies |
| Street Address |
9200 W WALKER RD |
| City | MANTON |
| State | MI |
| Zip Code | 49663-9315 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437626256 | Carrie Lynn Dextrom | Adult Companion | 9200 W Walker Rd, Manton, MI 49663-9315 | 2018-10-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639454986 | Manton Family Pharmacy Inc | Pharmacy | 117 W Main St, Manton, MI 49663 | 2011-10-19 |
| 1477641926 | Bostick Drug Store Inc | Pharmacy | 117 W Main St, Manton, MI 49663 | 2006-10-10 |
| 1669862546 | Hilda Schut | Massage Therapist | 7144 E 14 Rd, Manton, MI 49663-8600 | 2015-01-29 |
| 1821549858 | Katie Gardner | Specialist/Technologist | 5851 W Moorestown Rd, Manton, MI 49663-9012 | 2016-10-14 |
| 1558900720 | Manton Family Pharmacy Inc | Pharmacy | 117 W Main St, Manton, MI 49663-9026 | 2020-01-05 |
| 1578817854 | Bonnie Lou Perkins/crackel | Contractor | 116 Roberts St, Manton, MI 49663-9124 | 2012-11-07 |
| 1093287203 | Stephen Hooper | Transportation Broker | 212 Pine St, Manton, MI 49663-9128 | 2018-12-28 |
| 1922551852 | Manton Medical Equipment, LLC | Health Maintenance Organization | 113 E Main St, Manton, MI 49663-9152 | 2016-07-27 |
| 1578992459 | Karla Long | Physical Therapy Assistant | 413 W Main St, Manton, MI 49663-9156 | 2013-11-01 |
| 1518358779 | Mary Schmidt | Registered Nurse | 9091 W Walker Rd, Manton, MI 49663-9311 | 2015-02-10 |
| Find all providers in zip 49663 | ||||
| Taxonomy Code | 253J00000X |
| Grouping | Agencies |
| Classification | Foster Care Agency |
| A Foster Care Agency is an agency that provides foster care as defined in the Code of Federal Regulations (CFR) as "24-hour substitute care for children outside their own homes." Foster care settings include, but are not limited to, nonrelative foster family homes, relative foster homes (whether payments are being made or not), group homes, emergency shelters, residential facilities, and pre-adoptive homes. |
| Notes: Source: Code Of Federal Regulations, Title 45, Volume 4, Part 1355, Section 57 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609474576 | Maryann Michelle Lavender | Foster Care Agency | 5633 Embassy St, Kalamazoo, MI 49009-6499 | 2020-10-13 |
| 1417560269 | Fountain of Love | Foster Care Agency | 2140 Dickerson St, Detroit, MI 48215-2640 | 2020-08-30 |
| 1376165076 | Haven Adult Foster Care Ltd | Foster Care Agency | 73600 Church St, Armada, MI 48005-4749 | 2020-05-15 |
| 1104448018 | Jody Elizabeth Josephson | Foster Care Agency | 7415 Dexter Pinckney Rd, Dexter, MI 48130-7505 | 2020-05-13 |
| 1639701600 | Colonial Park Adult Assisted Living | Foster Care Agency | 1050 W Colonial Park Dr, Grand Ledge, MI 48837-2215 | 2020-02-07 |
| 1972135200 | Absolute Care LLC | Foster Care Agency | 5847 Naneva Ct, West Bloomfield, MI 48322-2517 | 2020-02-05 |
| 1699315556 | Reliance Manor LLC | Foster Care Agency | 35156 Ecorse Rd, Romulus, MI 48174-1640 | 2020-01-08 |
| 1215573217 | Byerly Enterprises, LLC | Foster Care Agency | 8616 Hidden Acre Ct, Clarkston, MI 48348-2895 | 2019-11-25 |
| 1235789553 | Dorthie Bolden | Foster Care Agency | 7027 Baseline Rd, South Haven, MI 49090-8338 | 2019-09-18 |
| 1457909509 | Sallie Mae Emert | Foster Care Agency | 2850 W Leinaar Rd, Delton, MI 49046-9567 | 2019-09-02 |
| Find all providers with the same taxonomy | ||||
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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.