IHS Acquisition No 111, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

634023 Issued in MI

Legal business name

IHS ACQUISITION NO 111, INC.

Doing business as

Clarkston Specialty Healthcare Center

Practice address

4800 Clintonville Rd
Clarkston, MI 48346-4297

Phone

(248) 674-0903

NPI assigned

Jun 7, 2007

Last updated

Oct 2, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Maggie Canny

Title

President

Phone

(248) 674-0903

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Clarkston Specialty Healthcare Center Doing business as

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191283200000",
    "number": "1205039146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 RIDGEBROOK ROAD",
            "city": "SPARKS",
            "state": "MD",
            "postal_code": "21152",
            "telephone_number": "410-773-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 CLINTONVILLE RD",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483464297",
            "telephone_number": "248-674-0903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IHS ACQUISITION NO 111, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-07",
        "last_updated": "2007-10-02",
        "status": "A",
        "authorized_official_last_name": "CANNY",
        "authorized_official_first_name": "MAGGIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-674-0903"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MI",
            "license": "634023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4608402",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clarkston Specialty Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Clarkston, MI
• Providers in Clarkston, MI by specialty
• Skilled Nursing Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2007; 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.