Mabel Avenue Home

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

License

AS250337649 Issued in MI

Legal business name

MABEL AVENUE HOME

Practice address

1446 Mabel Ave
Flint, MI 48506-3343

Phone

(810) 820-7279

Fax

(810) 820-7279

NPI assigned

Apr 3, 2013

Organization subpart

No

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

Authorized official

Name

Ms. Mary Ann Lewis

Title

Owner

Phone

(810) 820-7279

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1364947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364947200000",
    "number": "1174866610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1446 MABEL AVE",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485063343",
            "telephone_number": "810-820-7279",
            "fax_number": "810-820-7279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1446 MABEL AVE",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485063343",
            "telephone_number": "810-820-7279",
            "fax_number": "810-820-7279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MABEL AVENUE HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-03",
        "last_updated": "2013-04-03",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "810-820-7279",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "MI",
            "license": "AS250337649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Exclusive Provider Organization in Flint, MI
• Providers in Flint, MI by specialty
• Exclusive Provider Organization in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2013; 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.