Otevwa Homes Inc

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

OTEVWA HOMES INC

Practice address

6556 Rustic Ridge TRL
Grand Blanc, MI 48439-4956

Phone

(313) 690-0667

NPI assigned

Aug 29, 2020

Organization subpart

No

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

Authorized official

Name

Tive Evwaraye

Title

Director

Phone

(313) 690-0667

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1598659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598659200000",
    "number": "1104439033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6556 RUSTIC RIDGE TRL",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484394956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6556 RUSTIC RIDGE TRL",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484394956",
            "telephone_number": "313-690-0667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OTEVWA HOMES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-29",
        "last_updated": "2020-08-29",
        "certification_date": "2020-08-29",
        "status": "A",
        "authorized_official_last_name": "EVWARAYE",
        "authorized_official_first_name": "TIVE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "313-690-0667"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Omonyemwen Osayande
• Carol Osborn, LMSW
• Christyl Lynn Osborne
• Wendy Osika, LMSW
• Abdulfatah Osman, M.D.
• Morgan Kiah Overstreet, LPC
• James E Owen, OD
• Alivia Beth Owens
• Tara Owens
• Carlos R Padilla, DO

• Multi-Specialty Clinic/Center in Grand Blanc, MI
• Providers in Grand Blanc, MI by specialty
• Multi-Specialty Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2020; 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.