Palmer'S Place Inc

Primary specialty

Custodial Care FacilityTaxonomy code 311Z00000X

Legal business name

PALMER'S PLACE INC

Practice address

1009 S. St. Johns Rd
Ithaca, MI 48847

Phone

(989) 875-3745

Fax

(989) 875-3759

NPI assigned

Feb 17, 2020

Organization subpart

No

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

Authorized official

Name

Jennia Mari Woodcock

Title

Administrator of Afc

Phone

(989) 444-1597

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1581897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581897600000",
    "number": "1164055380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11345 W. ST. CHARLES RD",
            "city": "SUMNER",
            "state": "MI",
            "postal_code": "48889",
            "telephone_number": "989-444-1597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1009 S. ST. JOHNS RD",
            "city": "ITHACA",
            "state": "MI",
            "postal_code": "48847",
            "telephone_number": "989-875-3745",
            "fax_number": "989-875-3759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMER'S PLACE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-17",
        "last_updated": "2020-02-17",
        "certification_date": "2020-02-17",
        "status": "A",
        "authorized_official_last_name": "WOODCOCK",
        "authorized_official_first_name": "JENNIA",
        "authorized_official_middle_name": "MARI",
        "authorized_official_title_or_position": "ADMINISTRATOR OF AFC",
        "authorized_official_telephone_number": "989-444-1597"
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 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.