Abbta Inc

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

AS390290297 Issued in MI

Legal business name

ABBTA INC

Practice address

5508 Mount Vernon Ave
Portage, MI 49024-1215

Phone

(269) 342-5886

NPI assigned

Apr 1, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Adebiyi Bill Aina, LBSW

Title

Owner/President

Phone

(269) 267-7404

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mt. Vernon AFC Doing business as

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

{
    "created_epoch": "1238544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238544000000",
    "number": "1073755336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1391",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490811391",
            "telephone_number": "269-342-5886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5508 MOUNT VERNON AVE",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490241215",
            "telephone_number": "269-342-5886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABBTA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-01",
        "last_updated": "2009-04-01",
        "status": "A",
        "authorized_official_last_name": "AINA",
        "authorized_official_first_name": "ADEBIYI",
        "authorized_official_middle_name": "BILL",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "269-267-7404",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LBSW"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "MI",
            "license": "AS390290297",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2097746",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mt. Vernon AFC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Adult Care Home Facility in Portage, MI
• Providers in Portage, 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 Apr 1, 2009; 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.