Fannview Afc LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

AS410317479 Issued in MI

Legal business name

FANNVIEW AFC LLC

Practice address

1948 Millbank St SE
Grand Rapids, MI 49508-2673

Phone

(616) 350-9124

NPI assigned

Feb 14, 2017

Organization subpart

No

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

Authorized official

Name

Nadine Carlson

Title

Owner

Phone

(248) 342-2698

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1487030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487030400000",
    "number": "1053850776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 HODENPYL RD SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495062060",
            "telephone_number": "248-342-2698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1948 MILLBANK ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495082673",
            "telephone_number": "616-350-9124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FANNVIEW AFC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-14",
        "last_updated": "2017-02-14",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "NADINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-342-2698"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "MI",
            "license": "AS410317479",
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "MI",
            "license": "AS410317479",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Win-CHI Fan, DC
• Xuejing Fan
• Jada Fannin
• Justin Shayne Fanning, MD
• Sherri Fannon
• Anthony G Fant Jr.
• Gerard Edward Farage, D.C
• Alberto Farah, M.D.
• Teresa R Farah, NP
• Kristi Farber

• Adult Care Home Facility in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Adult Care Home Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2017; 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.