Mi Independent Living LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

MI INDEPENDENT LIVING LLC

Practice address

1526 N Mitchell St
Cadillac, MI 49601-1131

Phone

(231) 942-2091

NPI assigned

Aug 23, 2024

Organization subpart

No

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

Authorized official

Name

Mr. Christopher L Thetford

Title

Owner

Phone

(231) 942-2091

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1724371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724371200000",
    "number": "1093548182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17330 HONOR HWY LOT 1",
            "city": "INTERLOCHEN",
            "state": "MI",
            "postal_code": "496439226",
            "telephone_number": "231-942-2091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1526 N MITCHELL ST",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496011131",
            "telephone_number": "231-942-2091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MI INDEPENDENT LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-23",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A",
        "authorized_official_last_name": "THETFORD",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "231-942-2091",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 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.