The Manor House

Primary specialty

Respite CareTaxonomy code 385H00000X

License

AF280260935 Issued in MI

Legal business name

THE MANOR HOUSE

Practice address

1258 Lake Dr
Traverse City, MI 49684-8288

Phone

(123) 194-7046

NPI assigned

Jun 7, 2009

Organization subpart

No

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

Authorized official

Name

Mrs. Betty Ann Reynolds-Maciejewski

Title

Owner

Phone

(231) 947-0463

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1244332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244332800000",
    "number": "1306072194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1258 LAKE DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496848288",
            "telephone_number": "123-194-7046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1258 LAKE DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496848288",
            "telephone_number": "123-194-7046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MANOR HOUSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-07",
        "last_updated": "2009-06-07",
        "status": "A",
        "authorized_official_last_name": "REYNOLDS-MACIEJEWSKI",
        "authorized_official_first_name": "BETTY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "12319470463",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "MI",
            "license": "AF280260935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Respite Care in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Respite Care in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2009; 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.