NPIMap

Organization Active NPI

Bertram's Manor LLC

  • Adult Care Home Facility
  • Flint, MI
National Provider Identifier
1215203054
Registry record updated Mar 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
License
AM250289405 Issued in MI
Legal business name
BERTRAM'S MANOR LLC
Practice address
1202 Church St
Flint, MI 48502-1015
Phone
(810) 238-1430
NPI assigned
Mar 27, 2012
Last updated
Mar 27, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2012

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

Authorized official

Name
Mr. Nicholas Burnett
Title
Owner
Phone
(810) 238-1430

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X AM250289405 MI Primary

Addresses

Primary practice location

1202 Church St
Flint, MI 48502-1015

Mailing address

1202 Church St
Flint, MI 48502-1015

National Provider Directory

National Provider Directory
Tax ID family
Bertram's Manor LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1332806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332806400000",
    "number": "1215203054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 CHURCH ST",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485021015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 CHURCH ST",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485021015",
            "telephone_number": "810-238-1430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERTRAM'S MANOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-27",
        "last_updated": "2012-03-27",
        "status": "A",
        "authorized_official_last_name": "BURNETT",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "810-238-1430",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "MI",
            "license": "AM250289405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2012; 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.