Phillips Manor Room and Board

Primary specialty

Foster Care AgencyTaxonomy code 253J00000X

Legal business name

PHILLIPS MANOR ROOM AND BOARD

Practice address

16215 Ferguson St
Detroit, MI 48235-3440

Phone

(313) 333-5989

NPI assigned

Nov 22, 2021

Organization subpart

No

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

Authorized official

Name

Mr. Charles Phillips Jr.

Title

Administrator

Phone

(313) 333-5989

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1637539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637539200000",
    "number": "1205593563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16215 FERGUSON ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482353440",
            "telephone_number": "313-333-5989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16215 FERGUSON ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482353440",
            "telephone_number": "313-333-5989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILLIPS MANOR ROOM AND BOARD",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-22",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-22",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "313-333-5989",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniele Sheree Phenix
• Mariamma Oomen Philip
• Philip A Philip, MD PHD FRCP
• Maurice Phillip Sr.
• Phillips Foot Clinic
• Alexandra Phillips
• Bethany Katherine Phillips, RN
• Danielle Marie Phillips, MSN, RN, CPNP
• Donald E Phillips
• Elgie E Phillips

• Foster Care Agency in Detroit, MI
• Providers in Detroit, MI by specialty
• Foster Care Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 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.