MR. MARK N ANDERSON (NPI# 1427247097) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427247097 |
| Entity Type | Individual |
| Full Name | MR. MARK N ANDERSON |
| Credential | BA |
| Practice Address |
17160 130th Ave Nunica MI 49448-9450 |
| Practice Telephone | 6168474460 |
| Practice Fax Number | 6168474467 |
| Mailing Telephone | 6168474460 |
| Mailing Fax Number | 6168474467 |
| Enumeration Date | 2007-10-19 |
| Last Update Date | 2007-10-19 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326607383 | Mark Anderson | Massage Therapist | 1978 Addison Ave E, Twin Falls, ID 83301-5304 | 2019-06-12 |
| 1427403468 | Mark Anthony Anderson | Student in an Organized Health Care Education/Training Program | 157 E Rose St, Lebanon, OR 97355-4231 | 2016-04-27 |
| 1356732887 | Mark David Anderson | Licensed Practical Nurse | 227 Island Cottage Rd., Rochester, NY 14612-3627 | 2015-02-05 |
| 1134562903 | Mark William Anderson | Marriage & Family Therapist | 500 S. 580 W., Escalante, UT 84726 | 2013-04-11 |
| 1629334073 | Mark Gruen Anderson | Pharmacist | 2615 Eastern Ave, Plymouth, WI 53073-4270 | 2012-04-10 |
| 1629342928 | Mark Anderson | Social Worker | 140 Griggs Dr, Princeton, NJ 08540-7672 | 2012-03-05 |
| 1912271818 | Mark D Anderson | Licensed Practical Nurse | 4210 Wood Park Dr, Stow, OH 44224-2651 | 2012-02-24 |
| 1982905261 | Mark Alan Anderson | Pharmacist | 860 N Cleveland Ave, Loveland, CO 80537-4717 | 2010-11-03 |
| 1487822771 | Mark R Anderson | Counselor | 106 N Kenosha Dr, Madison, WI 53705-2633 | 2008-02-20 |
| 1174736953 | Mark Arthur Anderson | Specialist | 333 O'connor Dr, San Jose, CA 95128 | 2007-05-08 |
| Street Address |
17160 130TH AVE |
| City | NUNICA |
| State | MI |
| Zip Code | 49448-9450 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043295934 | Hope Network Behavioral Health Services | Clinic/Center | 17160 130th Ave, Nunica, MI 49448-9450 | 2005-12-13 |
| 1790310589 | Jessie Lynn Vandonkelaar | Registered Nurse | 17160 130th Ave, Nunica, MI 49448-9450 | 2020-03-11 |
| 1326688912 | Tara Cuti | Registered Nurse | 17160 130th Ave, Nunica, MI 49448-9450 | 2020-01-10 |
| 1235610197 | Iesha Collins | Psychologist | 17160 130th Ave, Nunica, MI 49448-9450 | 2018-08-28 |
| 1962911230 | Alyssa Nicole Otten | Psychologist | 17160 130th Ave, Nunica, MI 49448-9450 | 2017-09-29 |
| 1174055057 | Amanda Sheffield | Social Worker | 17160 130th Ave, Nunica, MI 49448-9450 | 2017-03-30 |
| 1992194849 | David Paul | Psychologist | 17160 130th Ave, Nunica, MI 49448-9450 | 2015-01-15 |
| 1407973787 | Holva Muraima Dalmasi | Case Manager/Care Coordinator | 17160 130th Ave, Nunica, MI 49448-9450 | 2007-03-23 |
| 1750445763 | Brenda Slagle | Registered Nurse | 17160 130th Ave, Nunica, MI 49448-9450 | 2006-12-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659990430 | Anna Mitchell | Dietitian, Registered | 13260 Patchin Dr, Nunica, MI 49448-9338 | 2020-04-13 |
| 1407305733 | Sharon Andree | Rehabilitation Practitioner | 16918 Birchview Ct, Nunica, MI 49448-9343 | 2016-09-28 |
| 1710471446 | Gregory G Lunt | Social Worker | 12965 State Rd, Nunica, MI 49448-9614 | 2018-06-16 |
| 1063922433 | Nicole Marie Vereeke | Social Worker | 14070 Cleveland St, Nunica, MI 49448-9665 | 2017-10-11 |
| 1851700801 | Kathleen Orlebeke | Occupational Therapist | 15950 132nd Ave, Nunica, MI 49448-9787 | 2014-08-04 |
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083237051 | Twin Doves I LLC | Community Based Residential Treatment Facility, Mental Illness | 48617 36th Ave., Bangor, MI 49013 | 2020-05-25 |
| 1104452812 | New Vision of Integrative Services, Inc | Community Based Residential Treatment Facility, Mental Illness | 3505 Walnut St Ste C, Inkster, MI 48141-2952 | 2020-03-14 |
| 1124665054 | Baseline, L.L.C. | Community Based Residential Treatment Facility, Mental Illness | 122 W Crosstown Pkwy, Kalamazoo, MI 49001-2742 | 2019-12-10 |
| 1407491277 | Twin Doves II LLC | Community Based Residential Treatment Facility, Mental Illness | 40739 80th Ave, Decatur, MI 49045-8158 | 2019-11-15 |
| 1710528617 | Larry J Graham Jr. | Community Based Residential Treatment Facility, Mental Illness | 1284 Maurer Ave, Pontiac, MI 48342-1960 | 2019-10-01 |
| 1447815469 | Rainbow Rehabilitation Centers, Inc. | Community Based Residential Treatment Facility, Mental Illness | 6200 Textile Rd, Ypsilanti, MI 48197 | 2019-05-06 |
| 1669937603 | Community Living Options | Community Based Residential Treatment Facility, Mental Illness | 1206 Bronson Cir, Kalamazoo, MI 49008-2325 | 2019-02-04 |
| 1235607854 | Csm Serenity Homes, LLC | Community Based Residential Treatment Facility, Mental Illness | 1714 W 32nd St, Holland, MI 49423-7311 | 2018-11-13 |
| 1750859229 | The Noble Home II, Inc | Community Based Residential Treatment Facility, Mental Illness | 327 E Grand Blvd, Detroit, MI 48207-3616 | 2018-11-02 |
| 1679048870 | Neighborhood Living Services,inc. | Community Based Residential Treatment Facility, Mental Illness | 23001 Norfolk St, Detroit, MI 48219-1185 | 2018-10-04 |
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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.