Mecca House Corporation

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

License

AS630012369 Issued in MI

Legal business name

MECCA HOUSE CORPORATION

Doing business as

Mecca House

Practice address

53 West Huron
Pontiac, MI 48342

Phone

(248) 335-3547

Fax

(248) 335-7449

NPI assigned

Jun 7, 2017

Last updated

Jun 20, 2018By 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

May Kinnard

Title

Administrator

Phone

(248) 335-3547

Specialties & licenses 1

Addresses

Other names 1

• Mecca House Doing business as

Locations

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

{
    "created_epoch": "1496793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529452800000",
    "number": "1245769991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 WEST HURON",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "48342",
            "telephone_number": "248-335-3547",
            "fax_number": "248-335-7449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 WEST HURON",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "48342",
            "telephone_number": "248-335-3547",
            "fax_number": "248-335-7449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MECCA HOUSE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-07",
        "last_updated": "2018-06-20",
        "status": "A",
        "authorized_official_last_name": "KINNARD",
        "authorized_official_first_name": "MAY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "248-335-3547"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "MI",
            "license": "AS630012369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mecca House",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shayla Alvina McMahon, DO
• Ioana Raluca Pencea McNally, DO
• April Elizabeth McNeill
• Dane McNelis
• Marie McRandall, P.T.
• Stephanie Elaine Mech
• Medical Associates Inc.
• Angela Delon Medlock, LMSW
• Serguei Medvedev, M.D
• Jevin Meghpara

• Assisted Living Facility (Mental Illness) in Pontiac, MI
• Providers in Pontiac, MI by specialty
• Assisted Living Facility (Mental Illness) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; 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.