SPECIALLY MADE CO. LLC (NPI# 1760030183) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1760030183 |
Entity Type | Organization |
Organization Name | SPECIALLY MADE CO. LLC |
Practice Address |
845 E Summerfield Glen Cir Ann Arbor MI 48103-9161 |
Mailing Address |
7631 N Dixboro Rd South Lyon MI 48178-7008 |
Practice Telephone | 2487904135 |
Mailing Telephone | 2487904135 |
Enumeration Date | 2019-08-28 |
Last Update Date | 2019-08-28 |
Authorized Official Name | KRISTIN KILL (PRES/CEO) |
Authorized Official Telephone | 2487904135 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
Street Address |
845 E SUMMERFIELD GLEN CIR |
City | ANN ARBOR |
State | MI |
Zip Code | 48103-9161 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1043839343 | Melissa Sylvia Danan Rilko | Social Worker | 1775 Timber Trail, Ann Arbor, MI 48103 | 2020-04-16 |
1427602929 | Ashwini Gulwadi, Pllc | Psychiatry & Neurology | 2100 S Main Street, Suite A, Unit 4, Ann Arbor, MI 48103 | 2019-08-01 |
1225593155 | Brent Aaron Reeve | Chiropractor | 203 S. Zeeb Rd., Suite 106, Ann Arbor, MI 48103 | 2019-02-05 |
1548746779 | Loren Camano Shkolnik | Registered Nurse | 3200 W Liberty Rd Ste C5, Ann Arbor, MI 48103 | 2018-07-11 |
1982193256 | Jacob B Nienhuis | Psychologist | 4488 Jackson Rd Ste 7b, Ann Arbor, MI 48103 | 2018-05-02 |
1053818633 | Regents of The University of Michigan | Eyewear Supplier (Equipment, not the service) | 380 Parkland Plz Ste 210, Ann Arbor, MI 48103 | 2018-04-10 |
1376052647 | Shivika Verma | Dentist | 3071 Signature Blvd, Apartment #f, Ann Arbor, MI 48103 | 2017-09-29 |
1881118206 | Harrison Udensi Igwe | Clinic/Center | 522 South Maple Stree, Ann Arbor, MI 48103 | 2017-07-27 |
1841727641 | Kathleen Murphy | Psychologist | 4141 Woodland Drive, Ann Arbor, MI 48103 | 2017-05-11 |
1972037133 | Jonathan Broek | Dietitian, Registered | 2920 Lakeview Dr, Ann Arbor, MI 48103 | 2017-04-14 |
Find all providers in zip 48103 |
Taxonomy Code | 320900000X |
Grouping | Residential Treatment Facilities |
Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144855123 | Hope Shores, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1383 E Maple Ave, Burton, MI 48529-2059 | 2020-03-10 |
1033776919 | South Coast Home LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 72633 M 43, South Haven, MI 49090-8734 | 2019-05-25 |
1275001448 | St. Jude's Assisted Living | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 509 S 22nd St, Escanaba, MI 49829-2247 | 2018-11-06 |
1457826315 | Northrop Loving Care | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 17777 Northrop St, Detroit, MI 48219-2321 | 2018-10-08 |
1548745961 | Residential Opportunities Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 612 Landsdowne Ave, Portage, MI 49002-0556 | 2018-10-02 |
1134604051 | Unity Group II LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 63 Wood Dr, Coldwater, MI 49036-1046 | 2018-09-26 |
1578048401 | Unity Group V LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 69 Wood Dr, Coldwater, MI 49036-1046 | 2018-09-26 |
1417432337 | Unity Group IIi LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1831 Case Dr, Union City, MI 49094-9348 | 2018-09-26 |
1033694963 | Unity Group Iv LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 126 Gail Ann Dr, Coldwater, MI 49036-9327 | 2018-09-26 |
1356826275 | Unity Group LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1861 B Case Drive, Union City, MI 49094 | 2018-09-26 |
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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.