MICHIGAN AVENUE RESIDENTIAL CARE INC. (NPI# 1891833414) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891833414 |
| Entity Type | Organization |
| Organization Name | MICHIGAN AVENUE RESIDENTIAL CARE INC. |
| Practice Address |
1204 W Michigan Ave Lansing MI 48915-1724 |
| Mailing Address |
2820 Woodview Dr Lansing MI 48911-1727 |
| Practice Telephone | 5173678172 |
| Practice Fax Number | 5178530791 |
| Mailing Telephone | 5173678172 |
| Mailing Fax Number | 5178530791 |
| Enumeration Date | 2007-02-03 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. HOPE MERCEDES LOVELL (PRESIDENT) |
| Authorized Official Telephone | 5173678172 |
| 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 | MI | Residential Treatment Facilities |
| Street Address |
1204 W MICHIGAN AVE |
| City | LANSING |
| State | MI |
| Zip Code | 48915-1724 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245844042 | Connie Elaine Crump | Home Health | 730 W. Ionia St Apt 303, Lansing, MI 48915 | 2020-08-31 |
| 1164905675 | Jenna Debryn | Counselor | The Guidance Center, 13101 Allen Rd. Building 4, Southgate, MI 48915 | 2018-09-11 |
| 1417315466 | Team Wellness | Community/Behavioral Health | 14799 Dix-toledo Rd, Southgate, MI 48915 | 2016-02-05 |
| 1154799419 | Amy S Campbell | Marriage & Family Therapist | 1805 Inverness Ave, Lansing, MI 48915 | 2015-09-03 |
| 1619206513 | Professional Peer Services | Community/Behavioral Health | 316 S Martin L King Blvd, # 2, Lansing, MI 48915 | 2009-12-24 |
| 1750551651 | Steven Shawn Sylvertooth | Physical Therapy Assistant | 818 Max Ave, Lansing, MI 48915-1016 | 2008-03-06 |
| 1225654361 | Latoria Hudson Mcdonald | Case Manager/Care Coordinator | 400 Everett Dr, Lansing, MI 48915-1106 | 2020-06-24 |
| 1174064901 | Kristen Cole Boeskool | Social Worker | 516 Everett Dr, Lansing, MI 48915-1108 | 2017-03-13 |
| 1245352087 | Maxine Thome | Social Worker | 1531 Osborn Rd, Lansing, MI 48915-1282 | 2007-04-04 |
| 1902432875 | Tiffany Jackson | Technician | 712 N Jenison Ave, Lansing, MI 48915-1309 | 2020-03-23 |
| Find all providers in zip 48915 | ||||
| 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 |
|---|---|---|---|---|
| 1245668854 | Dominion Cila Homes Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3043 Ridge Rd Ste 201, Lansing, IL 60438-3080 | 2013-10-16 |
| 1649618562 | Omni Visions, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 307 Shady Ln, Lansing, NC 28643-9168 | 2013-06-13 |
| 1467703165 | Yolanda Santos | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3285 W Stoll Rd, Lansing, MI 48906-9357 | 2012-09-21 |
| 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 |
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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.