DETROIT FAMILY HOME (NPI# 1609209634) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609209634 |
| Entity Type | Organization |
| Organization Name | DETROIT FAMILY HOME |
| Practice Address |
17180 Indiana St Detroit MI 48221-2445 |
| Practice Telephone | 3132707751 |
| Practice Fax Number | 3132707291 |
| Mailing Telephone | 3132707751 |
| Mailing Fax Number | 3132707291 |
| Enumeration Date | 2013-08-13 |
| Last Update Date | 2017-12-22 |
| Authorized Official Name | MR. JEAN FELIX NYAMBIO (CEO) |
| Authorized Official Telephone | 3013323009 |
| Authorized Official Credential | CRNA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 320700000X | Residential Treatment Facility, Physical Disabilities | AS820338244 | MI | Residential Treatment Facilities |
| N | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
AS820338244 | MI | Nursing & Custodial Care Facilities |
| N | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | AS820338244 | MI | Residential Treatment Facilities |
| N | 320800000X | Community Based Residential Treatment Facility, Mental Illness | AS820338244 | MI | Residential Treatment Facilities |
| N | 385H00000X | Respite Care | AS820338244 | MI | Respite Care Facility |
| Y | 311Z00000X | Custodial Care Facility | AS82033824 | MI | Nursing & Custodial Care Facilities |
| N | 385HR2060X |
Respite Care Specialization: Respite Care, Mental Retardation and/or Developmental Disabilities, Child |
AS820338244 | MI | Respite Care Facility |
| Street Address |
17180 INDIANA ST |
| City | DETROIT |
| State | MI |
| Zip Code | 48221-2445 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992359285 | Sutherlond Homes | Home Infusion | 20499 Ilene, Detroit, MI 48221 | 2019-07-25 |
| 1447743216 | Prolific Care Home Health Svc | Home Health | 10141 W. Mcnichols St., Detroit, MI 48221 | 2018-06-07 |
| 1982103297 | Diamond A Lowe | Technician/Technologist | 16654 Monte Vista, Detroit, MI 48221 | 2018-02-02 |
| 1356871941 | Tamika Baines | Driver | 19939 Indiana, Detroit, MI 48221 | 2017-06-15 |
| 1821535667 | Tanisha Floyd | Behavior Technician | 18307 Mendota St., Detroit, MI 48221 | 2017-01-31 |
| 1225585250 | Maan Down LLC | Custodial Care Facility | 16885 Ilene St, Detroit, MI 48221 | 2016-09-07 |
| 1285013979 | Thiera Danyal Lane | Counselor | 11000 W Mcnichols Rd Ste 309, Detroit, MI 48221 | 2015-05-27 |
| 1679967038 | Remy Onimoe | Pharmacist | 16191 Livernois Avenue, Southfield, MI 48221 | 2015-03-24 |
| 1669863098 | Loving Hands Accessible Service L.L.C. | Driver | 16230 Mendota, Detroit, MI 48221 | 2015-02-06 |
| 1487916433 | Social Care Administrators LLC | Case Management | 11000 W. Mcnicholas, Ste 212, Detroit, MI 48221 | 2012-06-14 |
| Find all providers in zip 48221 | ||||
| Taxonomy Code | 311Z00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| A facility providing care that serves to assist an individual in the activities of daily living, such as assistance in walking, getting in and out of bed, bathing, dressing, feeding, and using the toilet, preparation of special diets, and supervision of medication that usually can be self-administered. Custodial care essentially is personal care that does not require the continuing attention of trained medical or paramedical personnel. |
| Notes: Source: Paraphrased from Section 3159 A3 of the Medicare Intermediary Manual. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346711546 | Nationwide Community Housing Inc | Custodial Care Facility | 14391 Coyle St, Detroit, MI 48227-2585 | 2018-12-16 |
| 1811291529 | Delightful Senior Care, LLC. | Custodial Care Facility | 17572 San Juan Dr, Detroit, MI 48221-2641 | 2011-01-10 |
| 1023310588 | Berry Adult Foster Care Homes Inc | Custodial Care Facility | 3640 Mcdougall St, Detroit, MI 48207-2344 | 2010-12-03 |
| 1619112554 | Exceptional Deliverence Ministries | Custodial Care Facility | 19774 Forrer St, Detroit, MI 48235-2307 | 2008-12-06 |
| 1437303104 | Beverly A Koonce | Custodial Care Facility | 16520 Whitcomb St, Detroit, MI 48235-3859 | 2008-11-07 |
| 1386094340 | City Home Care, LLC | Custodial Care Facility | 17183 Griggs St, Detroit, MI 48221-2426 | 2016-06-20 |
| 1679881478 | Wayne County Juvenile Detention Facility | Custodial Care Facility | 1326 Saint Antoine St, Detroit, MI 48226-2301 | 2010-09-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518564715 | Nicole Marie Hutchinson | Custodial Care Facility | 519 S Vander Meulen Rd, Lake City, MI 49651-8717 | 2020-10-01 |
| 1831796028 | Sheila Ann Breiler | Custodial Care Facility | 631 S Vander Meulen Rd, Lake City, MI 49651-9367 | 2020-10-01 |
| 1033726427 | M & T Adult Foster Care, Inc | Custodial Care Facility | 5478 210th Ave, Reed City, MI 49677-8626 | 2020-09-29 |
| 1457974388 | Leeanne Marie Love Woolley | Custodial Care Facility | 621 S M 30, Gladwin, MI 48624-8443 | 2020-05-27 |
| 1326675950 | Timothy Alan Rantz | Custodial Care Facility | 1564 N M 63, Benton Harbor, MI 49022-2759 | 2020-03-24 |
| 1437782075 | Sharon Lynn Dewey | Custodial Care Facility | 1425 Ziggy Rd., Farwell, MI 48622 | 2020-02-21 |
| 1164055380 | Palmer's Place Inc | Custodial Care Facility | 1009 S. St. Johns Rd, Ithaca, MI 48847 | 2020-02-17 |
| 1508400771 | Margaret M Dandron | Custodial Care Facility | 5740 Twin Lake Ave, Lake, MI 48632 | 2019-10-31 |
| 1831747500 | Rhonda L Owens | Custodial Care Facility | 3819 S Wise Rd, Mount Pleasant, MI 48858-8100 | 2019-08-27 |
| 1164905683 | Autumn Ridge Gardens | Custodial Care Facility | 412 Marsac St, Bay City, MI 48708-7780 | 2018-09-11 |
| 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.