SE Michigan Senior Services LLC

Primary specialty

Home Delivered MealsTaxonomy code 332U00000X

Legal business name

SE MICHIGAN SENIOR SERVICES LLC

Doing business as

Baldwin House Lakeside I, Lakeside II & Oakland

Practice address

1915 Baldwin Ave
Pontiac, MI 48340-1173

Phone

(248) 335-7020

Fax

(248) 335-0141

NPI assigned

Oct 5, 2021

Organization subpart

No

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

Authorized official

Name

Jillian J Tisch

Title

Authorized Personnel

Phone

(248) 545-0707

Specialties & licenses 2

Addresses

Other names 1

• Baldwin House Lakeside I, Lakeside II & Oakland Doing business as

Locations

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

{
    "created_epoch": "1633392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634515200000",
    "number": "1164194403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6905 TELEGRAPH RD STE 360",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483013189",
            "telephone_number": "248-545-0707",
            "fax_number": "248-545-0270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1915 BALDWIN AVE",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483401173",
            "telephone_number": "248-335-7020",
            "fax_number": "248-335-0141"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15731 19 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Clinton Township",
            "state": "MI",
            "postal_code": "480386315",
            "country_code": "US",
            "telephone_number": "586-263-0081",
            "fax_number": "586-412-1672",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15821 19 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Clinton Township",
            "state": "MI",
            "postal_code": "480386320",
            "country_code": "US",
            "telephone_number": "586-228-8889",
            "fax_number": "586-263-9486",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SE MICHIGAN SENIOR SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-05",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A",
        "authorized_official_last_name": "TISCH",
        "authorized_official_first_name": "JILLIAN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "AUTHORIZED PERSONNEL",
        "authorized_official_telephone_number": "248-545-0707"
    },
    "taxonomies": [
        {
            "code": "332U00000X",
            "taxonomy_group": "",
            "desc": "Home Delivered Meals",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baldwin House Lakeside I, Lakeside II & Oakland",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Margaret Mary Schroer
• Susan Schumacher, LLMSW
• Charles Schwartz, M.D.
• April Colette Scott
• Yolanda Louise Scott
• Albert Seaman, CRNA
• Kenneth Earl Searcy
• Alexandra Gabriela Seas, MD
• Mathew Secord, DO
• Seera LLC

• Home Delivered Meals in Pontiac, MI
• Providers in Pontiac, MI by specialty
• Home Delivered Meals in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2021; 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.