NPIMap

Organization Active NPI

Tustin House LLC

  • Foster Care Agency
  • Tustin, MI
National Provider Identifier
1003645680
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foster Care AgencyTaxonomy code 253J00000X
Legal business name
TUSTIN HOUSE LLC
Practice address
17544 20 Mile Rd
Tustin, MI 49688-8514
Phone
(231) 429-4941
Fax
(231) 306-5912
NPI assigned
Jul 31, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Nicole Mekenzie Haney
Title
Owner
Phone
(231) 429-4941

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foster Care Agency 253J00000X Primary

Addresses

Primary practice location

17544 20 Mile Rd
Tustin, MI 49688-8514

Mailing address

17544 20 Mile Rd
Tustin, MI 49688-8514
Phone (231) 429-4941

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1722384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722384000000",
    "number": "1003645680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17544 20 MILE RD",
            "city": "TUSTIN",
            "state": "MI",
            "postal_code": "496888514",
            "telephone_number": "231-429-4941",
            "fax_number": "231-306-5912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17544 20 MILE RD",
            "city": "TUSTIN",
            "state": "MI",
            "postal_code": "496888514",
            "telephone_number": "231-429-4941",
            "fax_number": "231-306-5912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TUSTIN HOUSE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-31",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A",
        "authorized_official_last_name": "HANEY",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "MEKENZIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "231-429-4941"
    },
    "taxonomies": [
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.