Active NPI
Oleesha Anderson
- Adult Care Home Facility
- Detroit, MI
National Provider Identifier
1114683380
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Care Home Facility
- Practice address
- 11313 Wade St
Detroit, MI 48213-1676 - Phone
- (313) 694-1590
- NPI assigned
- Nov 12, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Care Home Facility | 311ZA0620X | Primary |
Addresses
Primary practice location
11313 Wade St
Detroit, MI 48213-1676
Mailing address
18548 Kingsville St
Harper Woods, MI 48225-2136
Phone (586) 935-7066
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000000 | Other | DONT HAVE ANY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1636675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1114683380",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18548 KINGSVILLE ST",
"city": "HARPER WOODS",
"state": "MI",
"postal_code": "482252136",
"telephone_number": "586-935-7066"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11313 WADE ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482131676",
"telephone_number": "313-694-1590"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "OLEESHA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-11-12",
"last_updated": "2022-07-21",
"certification_date": "2021-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "311ZA0620X",
"taxonomy_group": "",
"desc": "Custodial Care Facility, Adult Care Home",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DONT HAVE ANY",
"identifier": "000000000",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.