Residecare LLC

Primary specialty

Physical Disabilities Residential Treatment FacilityTaxonomy code 320700000X

Legal business name

RESIDECARE LLC

Practice address

1161 Nash Ave
Ypsilanti, MI 48198-6291

Phone

(734) 460-2558

Fax

(734) 533-6066

NPI assigned

Mar 26, 2024

Organization subpart

No

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

Authorized official

Name

Susan Catherman

Title

Credentialing

Phone

(267) 767-6851

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1711411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711411200000",
    "number": "1093565590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 970235",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481970031",
            "fax_number": "269-666-6098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1161 NASH AVE",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481986291",
            "telephone_number": "734-460-2558",
            "fax_number": "734-533-6066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESIDECARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-26",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A",
        "authorized_official_last_name": "CATHERMAN",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "267-767-6851"
    },
    "taxonomies": [
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Disabilities Residential Treatment Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 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.