COUNTRY LIVING ADULT FOSTER CARE (NPI# 1619274669) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619274669 |
| Entity Type | Organization |
| Organization Name | COUNTRY LIVING ADULT FOSTER CARE |
| Practice Address |
16966 6 Mile Rd Stanwood MI 49346-9104 |
| Practice Telephone | 2318232061 |
| Practice Fax Number | 2318232061 |
| Mailing Telephone | 2318232061 |
| Mailing Fax Number | 2318232061 |
| Enumeration Date | 2011-02-26 |
| Last Update Date | 2011-02-26 |
| Authorized Official Name | MS. GAIL ANN DAWSON (OWNER) |
| Authorized Official Telephone | 2318232061 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3104A0625X |
Assisted Living Facility Specialization: Assisted Living, Mental Illness |
AS540307174 | MI | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | LICENSE # | AS540307174 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083874242 | Country Living Adult Foster Care | Foster Care Agency | 175 County Road 6721, Natalia, TX 78059-2123 | 2008-06-11 |
| 1326683475 | Country Living Adult Foster Care | Foster Care Agency | 175 County Road 6721, Natalia, TX 78059-2123 | 2019-11-13 |
| Street Address |
16966 6 MILE RD |
| City | STANWOOD |
| State | MI |
| Zip Code | 49346-9104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114134681 | Gregerson Radiology Consultants Ltd. | Chiropractor | 8004 Red Fox Rd, Stanwood, MI 49346 | 2007-05-16 |
| 1073969960 | Spine By Design Inc. | Chiropractor | 10032 Buchanan Rd, Stanwood, MI 49346 | 2016-05-10 |
| 1619912714 | James D Biederbeck | Physical Therapist | 8354 100th Ave, Suite 2, Canadian Lakes, MI 49346-8333 | 2006-06-20 |
| 1760435317 | Mecosta County Medical Center | Home Health | 8354 100th Ave, Suite 3, Canadian Lakes, MI 49346-8344 | 2006-05-17 |
| 1730748609 | Katelin Anne Aris | Nurse Practitioner | 8354 100th Ave, Stanwood, MI 49346-8344 | 2019-06-13 |
| 1942693106 | Mecosta County Medical Center | Social Worker | 8354 100th Ave, Stanwood, MI 49346-8344 | 2015-03-12 |
| 1699104315 | Tiffany L Lattimore | Physician Assistant | 8354 100th Ave, Stanwood, MI 49346-8344 | 2013-11-04 |
| 1811152127 | Erin Patrece Dressander | Physical Therapist | 8354 100th Ave, Ste 2, Canadian Lakes, MI 49346-8344 | 2008-07-25 |
| 1912044215 | Eva Leigh Bartlett | Family Medicine | 8354 100th Ave, Canadian Lakes, MI 49346-8344 | 2007-01-30 |
| 1881620359 | Michelle Rose Godfrey | Physician Assistant | 8354 100th Ave, Suite 1, Stanwood, MI 49346-8344 | 2006-06-24 |
| Find all providers in zip 49346 | ||||
| Taxonomy Code | 3104A0625X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| Specialization | Assisted Living, Mental Illness |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154947703 | Bay City Comfort Care | Assisted Living Facility | 4130 Shrestha Dr, Bay City, MI 48706-2184 | 2020-06-19 |
| 1548807142 | Mother of Grace LLC | Assisted Living Facility | 7947 Tulane St, Taylor, MI 48180-2321 | 2019-12-03 |
| 1881231629 | Better Life Residential Care Inc | Assisted Living Facility | 4444 Lincoln Blvd, Dearborn Hts, MI 48125-2568 | 2019-11-27 |
| 1700433042 | Golden Life Afc LLC | Assisted Living Facility | 10710 Roy Dr, Greenville, MI 48838-9105 | 2019-08-21 |
| 1225513468 | Harmony Hearts Village LLC | Assisted Living Facility | 7773 Sherwood St, Detroit, MI 48211-1785 | 2018-10-03 |
| 1699277004 | Leann Renee Gastelum | Assisted Living Facility | 19301 Winthrop St, Detroit, MI 48235 | 2018-03-01 |
| 1245769991 | Mecca House Corporation | Assisted Living Facility | 53 West Huron, Pontiac, MI 48342 | 2017-06-07 |
| 1225564768 | Country Haven | Assisted Living Facility | 413 E Muskegon St, Cedar Springs, MI 49319-9596 | 2017-05-03 |
| 1205382389 | B&r Holistic Care Housing, LLC | Assisted Living Facility | 19303 Mark Twain St, Detroit, MI 48235-1914 | 2016-08-29 |
| 1841683158 | Hill's Support Services Inc. | Assisted Living Facility | 6430 Washington St, Romulus, MI 48174-1742 | 2015-03-11 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on COUNTRY LIVING ADULT FOSTER CARE.
| 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.