Pdhcrc, Inc.

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

PDHCRC, INC.

Practice address

2111 Bondsteel Dr.
Jackson, MI 49202

Phone

(517) 784-4426

NPI assigned

Jan 31, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Karrie Beilfuss

Title

Ceo

Phone

(517) 748-7071

Specialties & licenses 7

Addresses

Other names 1

• Potential Development Homes, Inc. Doing business as

Tax ID family

Joey'S Junction2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Lifespan...a Community Service

  • Respite Care
  • Jackson, MI
  • NPI 1093041576
  NPD tax ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jessica Hayden, BS

  • Case Manager/Care Coordinator
  • Jackson, MI
  • NPI 1679373344
  NPD
• Chloe Melville-Schweda

  • Case Manager/Care Coordinator
  • Jackson, MI
  • NPI 1275490484
  NPD (past)

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715126400000",
    "number": "1164569802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 17TH ST",
            "address_2": "P.O. BOX 1978",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492031403",
            "telephone_number": "517-784-4426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2111 BONDSTEEL DR.",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "49202",
            "telephone_number": "517-784-4426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PDHCRC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2024-05-08",
        "status": "A",
        "authorized_official_last_name": "BEILFUSS",
        "authorized_official_first_name": "KARRIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "517-748-7071",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "MI",
            "license": "AL380007055",
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "MI",
            "license": "AL380007055",
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "MI",
            "license": "AL380007059",
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": "MI",
            "license": "DC380253832",
            "primary": false
        },
        {
            "code": "385HR2065X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Physical Disabilities, Child",
            "state": "MI",
            "license": "DC380253832",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Potential Development Homes, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Holly Jo Paul, NP
• Dalila Sharon Diane Payne
• Edwin Payne, LPC
• Kylie Payne
• Salina Payne
• Pearle Vision Inc
• Pediatric Center of Jackson
• Pediatric Dentistry and Orthodontics of Jackson
• Brent Peek
• Dirk Peeters, PA-C

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Jackson, MI
• Providers in Jackson, MI by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 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.