KAIROS HEALTHCARE INCORPORATED (NPI# 1427162239) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427162239 |
| Entity Type | Organization |
| Organization Name | KAIROS HEALTHCARE INCORPORATED |
| Practice Address |
6379 Dixie Hwy Bridgeport MI 48722-9566 |
| Practice Telephone | 9897774357 |
| Practice Fax Number | 9897777257 |
| Mailing Telephone | 9897774357 |
| Mailing Fax Number | 9897777257 |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2008-01-02 |
| Authorized Official Name | MR. FRED E. WIGEN JR. (PRESIDENT/CEO) |
| Authorized Official Telephone | 9897774357 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
730157 | MI | Behavioral Health & Social Service Providers |
| N | 104100000X | Social Worker | 730157 | MI | Behavioral Health & Social Service Providers |
| N | 324500000X | Substance Abuse Rehabilitation Facility | 730157 | MI | Residential Treatment Facilities |
| Y | 3245S0500X |
Substance Abuse Rehabilitation Facility Specialization: Substance Abuse Treatment, Children |
730157 | MI | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | HEALTH PLUS PIN | 0K47927 | 01 |
| MI | BCBS OF MI | 20520 | 01 |
| MI | VALUE OPTIONS PIN | 328565 | 01 |
| MI | MCARE PIN | 14072 | 01 |
| MI | MCCLAREN PIN | 1008848 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417023607 | Kairos Healthcare Incorporated | Substance Abuse Rehabilitation Facility | 1321 S Fayette St, Saginaw, MI 48602-1447 | 2006-11-28 |
| 1184758435 | Kairos Healthcare Incorporated | Social Worker | 6379 Dixie Hwy, Bridgeport, MI 48722-9566 | 2007-03-16 |
| 1174690648 | Kairos Healthcare Incorporated | Counselor | 1321 S Fayette St, Saginaw, MI 48602-1447 | 2006-11-29 |
| 1750457958 | Kairos Healthcare Incorporated | Counselor | 20400 Superior Rd, Taylor, MI 48180-5362 | 2006-11-28 |
| Street Address |
6379 DIXIE HWY |
| City | BRIDGEPORT |
| State | MI |
| Zip Code | 48722-9566 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376847202 | Joan Renee Patten | Social Worker | 6379 Dixie Hwy, Bridgeport, MI 48722-9566 | 2011-01-07 |
| 1285938126 | Amanda Neal | Counselor | 6379 Dixie Hwy, Bridgeport, MI 48722-9566 | 2011-01-07 |
| 1720382625 | Lakeshia J Scott | Counselor | 6379 Dixie Hwy, Bridgeport, MI 48722-9566 | 2011-01-06 |
| 1568763274 | Sawyer Plume | Counselor | 6379 Dixie Hwy, Bridgeport, MI 48722-9566 | 2010-11-11 |
| 1750682464 | Amy Norton-varela | Counselor | 6379 Dixie Hwy, Bridgeport, MI 48722-9566 | 2010-11-11 |
| 1205143336 | Latasha Renee Chesson | Social Worker | 6379 Dixie Hwy, Bridgeport, MI 48722-9566 | 2010-09-10 |
| 1578870606 | Megan Mane Frost | Counselor | 6379 Dixie Hwy, Bridgeport, MI 48722-9566 | 2010-09-10 |
| 1811204688 | Carolyn Ann Surles | Counselor | 6379 Dixie Hwy, Bridgeport, MI 48722-9566 | 2010-09-01 |
| 1386964039 | Dawnika L Cope | Counselor | 6379 Dixie Hwy, Bridgeport, MI 48722-9566 | 2010-06-04 |
| 1356661391 | Sara Jean Peeples | Counselor | 6379 Dixie Hwy, Bridgeport, MI 48722-9566 | 2010-06-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710584305 | Ryan Abraham Labean | Behavior Technician | 6296 Village Square Drive, Suite 2, Bridgeport, MI 48722 | 2020-10-06 |
| 1760787360 | Melinda Eve Bierlein | Physical Therapist | 5460 W. Rolling Hills Drive, Bridgeport, MI 48722 | 2011-01-13 |
| 1376016261 | Guidepost Counseling Services, Pllc | Counselor | 7274 Dixie Hwy, Bridgeport, MI 48722 | 2019-01-03 |
| 1497098594 | Nicole Marie Judson | Physical Therapist | 5460 W Rolling Hills Dr, Bridgeport, MI 48722 | 2013-03-27 |
| 1255472114 | Boettcher Home Medical Supply, LLC | Durable Medical Equipment & Medical Supplies | 6230 Dixie Hwy, Bridgeport, MI 48722-9513 | 2007-02-12 |
| 1356308480 | Bridgeport Pharmacy, Inc | Durable Medical Equipment & Medical Supplies | 6226 Dixie Hwy, Bridgeport, MI 48722-9513 | 2006-05-01 |
| 1114917242 | Bridgeport Pharmacy Inc | Pharmacist | 6224 Dixie Hwy, Bridgeport, MI 48722-9513 | 2005-10-28 |
| 1922581131 | Midmichigan Rx Services LLC | Pharmacy | 6224 Dixie Hwy, Bridgeport, MI 48722-9513 | 2018-09-13 |
| 1184120990 | Hemang Vinodchandra Patel | Pharmacist | 6224 Dixie Hwy, Bridgeport, MI 48722-9513 | 2018-04-02 |
| 1538674163 | Midmichigan Rx Services LLC | Pharmacy | 6224 Dixie Hwy, Bridgeport, MI 48722-9513 | 2017-12-05 |
| Find all providers in zip 48722 | ||||
| Taxonomy Code | 3245S0500X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| Specialization | Substance Abuse Treatment, Children |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of children with disorders in the use of drugs, alcohol, and other substances. Medical and supportive counseling services and education services are included. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972156701 | Flint Odyssey House Inc. | Substance Abuse Rehabilitation Facility | 932 Beach St, Flint, MI 48502-1502 | 2019-07-21 |
| 1669899241 | Great Lakes Recovery Centers, Inc. | Substance Abuse Rehabilitation Facility | 104 Malton Road, Negaunee, MI 49866 | 2014-03-21 |
| 1851682215 | Detroit Rescue Mission Ministries | Substance Abuse Rehabilitation Facility | 19211 Anglin, Detroit, MI 48234 | 2011-04-20 |
| 1881921401 | Todd-phillips Children's Home | Substance Abuse Rehabilitation Facility | 8141 E Outer Dr, Detroit, MI 48213-1323 | 2009-11-04 |
| 1851544688 | Lois Ann Brown-nelson | Substance Abuse Rehabilitation Facility | 14460 Mayfield St, Detroit, MI 48205-4131 | 2008-10-24 |
| 1891978441 | Wolverine Human Services | Substance Abuse Rehabilitation Facility | 150 Enterprise Dr, Vassar, MI 48768-9584 | 2007-12-06 |
| 1588706915 | Starr Commonwealth | Substance Abuse Rehabilitation Facility | 13725 Starr Commonwealth, Albion, MI 49224-9580 | 2007-02-13 |
| 1891851226 | P.e.a.c.e. In Young Life Center, Inc. | Substance Abuse Rehabilitation Facility | 15471 Cloverlawn St, Ste 101, Detroit, MI 48238-1146 | 2006-12-29 |
| 1831682947 | Michele Baldori | Substance Abuse Rehabilitation Facility | 50430 School House Rd, Canton, MI 48187-5910 | 2018-06-13 |
| 1982128393 | Flint Odyssey House, Inc. | Substance Abuse Rehabilitation Facility | 718 Oak St, Flint, MI 48503-2614 | 2017-07-27 |
| Find all providers with the same taxonomy | ||||
| City | BRIDGEPORT |
| Zip Code | 48722 |
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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.