Active NPI
Lora Jean Davis, ARDMS, AFC
- Adult Care Home Facility
- Dearborn, MI
National Provider Identifier
1255970430
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Care Home Facility
- Practice address
- 3307 Houston St
Dearborn, MI 48124-4159 - Phone
- (313) 278-2805
- Fax
- (313) 278-5243
- NPI assigned
- Jan 5, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Disabilities Residential Treatment Facility | 320700000X | MI | ||
| Mental Illness Community Based Residential Treatment Facility | 320800000X | MI | ||
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X | MI | ||
| Adult Care Home Facility | 311ZA0620X | MI | Primary |
Addresses
Primary practice location
3307 Houston St
Dearborn, MI 48124-4159
Mailing address
PO Box 2977
Southfield, MI 48037-2977
Phone (313) 590-9139
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Daviscarenetwork Inc | Adult Care Home | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Adult Care Home Facility
- Dearborn, MI
- NPI 1922856558
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1578182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643932800000",
"number": "1255970430",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2977",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480372977",
"telephone_number": "313-590-9139",
"fax_number": "313-278-5243"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3307 HOUSTON ST",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481244159",
"telephone_number": "313-278-2805",
"fax_number": "313-278-5243"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "LORA",
"middle_name": "JEAN",
"credential": "ARDMS, AFC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-01-05",
"last_updated": "2022-02-04",
"certification_date": "2022-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "320700000X",
"taxonomy_group": "",
"desc": "Residential Treatment Facility, Physical Disabilities",
"state": "MI",
"license": null,
"primary": false
},
{
"code": "320800000X",
"taxonomy_group": "",
"desc": "Community Based Residential Treatment Facility, Mental Illness",
"state": "MI",
"license": null,
"primary": false
},
{
"code": "320900000X",
"taxonomy_group": "",
"desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
"state": "MI",
"license": null,
"primary": false
},
{
"code": "311ZA0620X",
"taxonomy_group": "",
"desc": "Custodial Care Facility, Adult Care Home",
"state": "MI",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dearborn, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.