MR. MARK FREDERIC PETERSON I


Address: 3351 36th St, Grand Rapids, MI 49331
Phone: 6168315659

MR. MARK FREDERIC PETERSON I (NPI# 1841474012) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1841474012
Entity Type Individual
Full Name MR. MARK FREDERIC PETERSON I
Practice Address 3351 36th St
Grand Rapids
MI 49331
Mailing Address 2285 Christine Ct Se
Grand Rapids
MI 49546
Practice Telephone 6168315659
Mailing Telephone 6168315659
Enumeration Date 2007-12-24
Last Update Date 2007-12-24
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 320900000X Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 6802071051 MI Residential Treatment Facilities

Other Providers MARK PETERSON

NPI Name Taxonomy Address Enumeration
1164069696 Mark Alan Peterson In Home Supportive Care 5870 Nw 54th Ct, Johnston, IA 50131-1418 2019-12-03
1780877258 Mark A. Peterson Counselor 7322 Scenic Oaks Cir, Austin, TX 78745-5217 2007-08-19
1871702076 Mark Clayton Peterson Dentist 1600 W Sunset Rd Ste B, Henderson, NV 89014-2655 2007-05-22
1558481366 Mark Theodore Peterson Specialist 5712 Newburg Rd, Rockford, IL 61108-6707 2007-03-29
1073608170 Mark A Peterson Dentist 7740 Bay St, Suite # 1, Sebastian, FL 32958-3427 2006-10-04
1689782864 Mark L Peterson Dentist 127 1/2 E Short St, Rigby, ID 83442-1422 2006-08-28
1528013661 Mark Edward Peterson Dentist 2440 Gaynor Nw, Grand Rapids, MI 49544-1830 2006-05-24
1699763607 Mark Delano Peterson Orthopaedic Surgery 1311 E Barnett Rd, Ste 201, Medford, OR 97504-8225 2005-10-12
1477551836 Mark Dean Peterson Chiropractor 5406 Alderson St, Schofield, WI 54476-2264 2005-07-11
1477043842 Mark Peterson Student in an Organized Health Care Education/Training Program 1115 20th St Ste 205, Huntington, WV 25703-2071 2018-05-11

Office Location

Street Address 3351 36TH ST
City GRAND RAPIDS
State MI
Zip Code 49331

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1295173771 Heather Marie Jones Optometrist 915 W. Green St Ste 101, Hastings, MI 49331 2013-06-06
1184732323 Alivio Corporation Durable Medical Equipment & Medical Supplies 901 W. Main Street, Suite C, Lowell, MI 49331 2006-08-28
1740707637 Parker Liu Pharmacist 11980 Fulton St E, Lowell, MI 49331 2017-08-23
1962482653 Martin D Vredenburg Dentist 1150 N Hudson St, Lowell, MI 49331-1000 2006-01-19
1407140197 Spectrum Health Primary Care Partners Internal Medicine 1150 N Hudson St, Lowell, MI 49331-1000 2011-05-31
1508034141 Lowell Medical Specialists, PC Internal Medicine 1150 N Hudson St, Lowell, MI 49331-1000 2008-02-18
1740660315 Patricia Sellner Specialist/Technologist 990 N Hudson St, Lowell, MI 49331-1006 2015-06-08
1508327370 Lydia Joan Gerard Registered Nurse 1060 Hunt St, Lowell, MI 49331-1079 2019-03-26
1154847184 Family Dentistry of Lowell Dentist 147 N Center St, Lowell, MI 49331-1207 2017-08-22
1669515813 Ann Cathleen Wilson Dentist 147 N Center St, Lowell, MI 49331-1207 2007-02-15
Find all providers in zip 49331

Taxonomy Information

Taxonomy Code 320900000X
Grouping Residential Treatment Facilities
Classification Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1851830947 Royal Care Home LLC Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 507 Fuller Ave Se, Grand Rapids, MI 49506-2526 2017-02-22
1447799259 Kleck Afc Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 631 3 Mile Rd Ne, Grand Rapids, MI 49505-3362 2017-02-14
1528260700 Real Life Living Services, Inc Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 2920 Fuller Ave Ne Ste 103, Grand Rapids, MI 49505-3458 2007-06-01
1366799900 Hope Network Behavoiral Health Services Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 3333 36th St Se, Grand Rapids, MI 49512-2809 2012-08-14
1376722868 Kent Residential Centers, Inc Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 1225 Lake Dr Se, Grand Rapids, MI 49506-1656 2007-10-31

Providers in the same taxonomy and state

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
1760030183 Specially Made Co. LLC Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 845 E Summerfield Glen Cir, Ann Arbor, MI 48103-9161 2019-08-28
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
Find all providers with the same taxonomy

Competitor

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City GRAND RAPIDS
Zip Code 49331

Improve Information

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Dataset Information

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.

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