Redwood

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

REDWOOD

Practice address

5425 Whipple Lake Rd
Clarkston, MI 48348-3058

Phone

(248) 394-1836

Fax

(248) 620-6061

NPI assigned

Jun 6, 2007

Organization subpart

No

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

Authorized official

Name

Reeta J Smith

Title

Executive Director

Phone

(248) 625-1280

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1215130554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3280 TRILLIUM LN",
            "city": "OXFORD",
            "state": "MI",
            "postal_code": "483715528",
            "telephone_number": "248-625-1280",
            "fax_number": "248-620-6061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5425 WHIPPLE LAKE RD",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483483058",
            "telephone_number": "248-394-1836",
            "fax_number": "248-620-6061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDWOOD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "REETA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "248-625-1280"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.