Fairfield Residential Care, Inc.

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

FAIRFIELD RESIDENTIAL CARE, INC.

Practice address

16554 Fairfield St
Detroit, MI 48221-3005

Phone

(313) 861-8123

NPI assigned

Feb 19, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Heidi L Luter, LPC

Title

Administrator

Phone

(313) 550-8126

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1265576540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17141 NEW JERSEY ST",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480752985",
            "telephone_number": "313-550-8126",
            "fax_number": "248-559-0974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16554 FAIRFIELD ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482213005",
            "telephone_number": "313-861-8123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRFIELD RESIDENTIAL CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LUTER",
        "authorized_official_first_name": "HEIDI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "313-550-8126",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Illness Community Based Residential Treatment Facility in Detroit, MI
• Providers in Detroit, MI by specialty
• Mental Illness Community Based 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.