ELSABETH ENGEDA (NPI# 1922544402) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922544402 |
| Entity Type | Individual |
| Full Name | ELSABETH ENGEDA |
| Practice Address |
4464 Hickory Drive Okemos MI 48864 |
| Mailing Address |
4464 Hickorywood Dr Okemos MI 48864-3076 |
| Practice Telephone | 5174026191 |
| Enumeration Date | 2017-01-09 |
| Last Update Date | 2017-01-09 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | MI | Residential Treatment Facilities |
| Street Address |
4464 HICKORY DRIVE |
| City | OKEMOS |
| State | MI |
| Zip Code | 48864 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972066348 | Jan J Stokosa | Prosthetic/Orthotic Supplier | 2145 University Park Drive, Suite 100, Okemos, MI 48864 | 2019-04-11 |
| 1194284067 | Bryan R Salminen | Counselor | 2127 University Drive Suite 300, Okemos, MI 48864 | 2019-03-19 |
| 1639678600 | Paula Veronica Yevilaf Neira | Behavior Technician | 3887 Okemos Rd Suite A1, Okemos, MI 48864 | 2018-02-06 |
| 1306364690 | Sally Ann Purdy | Social Worker | 3493 Woods Edge Dr., Suite #103, Okemos, MI 48864 | 2017-09-06 |
| 1952824609 | Victoria Marie Hopper | Behavior Technician | 3887 Okemos Rd., Suite #a1, Okemos, MI 48864 | 2017-07-24 |
| 1134653306 | Kayleigh Delaney | Dietitian, Registered | 5050 Marsh Road, Suite 5, Okemos, MI 48864 | 2017-04-14 |
| 1104373752 | Joslyn Fraidenburg | Registered Nurse | 2322 Knod Hill Dr, Apt 14, Okemos, MI 48864 | 2016-09-01 |
| 1851748966 | Doug Derdowski | Social Worker | 4123 Okemos Road, Eastbrook Plaza, Okemos, MI 48864 | 2016-05-18 |
| 1437505971 | Jessica Lynn Reslock | Occupational Therapist | 2378 Woodlake Dr. Suite 280, Children's Therapy Corner, Okemos, MI 48864 | 2016-05-13 |
| 1548615271 | Misty Herson | Behavioral Analyst | 3387 Okemos Rd, Ste. A1, Okemos, MI 48864 | 2016-05-02 |
| Find all providers in zip 48864 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770199507 | Laura Lisa Gonzalez | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 7134 Blankenship Cir, Davison, MI 48423-2317 | 2020-09-17 |
| 1558984377 | Angel Patient Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 12601 E Outer Dr, Detroit, MI 48224-4204 | 2020-05-27 |
| 1659990208 | Lydias House | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 11667 152nd Ave, West Olive, MI 49460-9232 | 2020-04-14 |
| 1124667118 | Alternative Community Living, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2678 S Waverly Hwy, Lansing, MI 48911-6303 | 2019-12-23 |
| 1215579537 | Eden Prairie Residential Care Services, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 302 Welch Blvd, Flint, MI 48503-1105 | 2019-10-09 |
| 1518428333 | Alternative Adult Residence LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 19163 Woodingham Dr, Detroit, MI 48221-1650 | 2019-03-26 |
| 1245701960 | Teresa Elaine Guzman | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 130 Marvin St, Battle Creek, MI 49017-8040 | 2018-12-06 |
| 1508334764 | Marquette Staffing Agency, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 592 Blemhuber Ave, Marquette, MI 49855-4818 | 2018-11-06 |
| 1912481235 | Adrienne Flowers | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 18403 Kentucky St, Detroit, MI 48221-2029 | 2018-09-21 |
| 1417431487 | Helping Hands Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 5116 18th Rd, Escanaba, MI 49829-9525 | 2018-09-17 |
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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.