Fountain of Love Assisted Living Inc

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

FOUNTAIN OF LOVE ASSISTED LIVING INC

Practice address

21820 Beverly St
Oak Park, MI 48237-2503

Phone

(248) 796-7291

NPI assigned

Aug 30, 2010

Organization subpart

No

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

Authorized official

Name

Ms. Shanell ClarkNPI 1972958106

Title

Officer

Phone

(248) 796-7291

Specialties & licenses 5

Addresses

Other names 1

• The Loving Head Quarter Other name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shanell Clark

  • Nursing Home Administrator
  • Oak Park, MI
  • NPI 1972958106
  NPD (past) Authorized official

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

{
    "created_epoch": "1283126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542240000000",
    "number": "1093021859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21820 BEVERLY ST",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482372503",
            "telephone_number": "248-796-7291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21820 BEVERLY ST",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482372503",
            "telephone_number": "248-796-7291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNTAIN OF LOVE ASSISTED LIVING INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-30",
        "last_updated": "2018-11-15",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "SHANELL",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "248-796-7291",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MI",
            "license": "AF630309030",
            "primary": false
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Loving Head Quarter",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "The Loving Head Quarter",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Foreward Logistics L.L.C.
• Chana Mina Forta, LLMSW
• Fortitude Counseling Services LLC
• Fortson Dental Oak Park P.C.
• Bernard Lejuan Foster
• Fountain of Love Assisted Living Sevices Inc
• Dalia Catherine Fragoso, LLMSW
• Wenaelle Francillon
• Francis Salwan DDS PC
• Vikita Franklin, LPN

• Clinical Social Worker in Oak Park, MI
• Providers in Oak Park, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2018; 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.