NPIMap

Organization Active NPI

Five Star Residential Inc

  • Foster Care Agency
  • Oak Park, MI
National Provider Identifier
1336546589
Registry record updated Dec 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foster Care AgencyTaxonomy code 253J00000X
License
AS630352375 Issued in MI
Legal business name
FIVE STAR RESIDENTIAL INC
Practice address
22190 Sussex St
Oak Park, MI 48237-3509
Phone
(248) 421-2735
Fax
(248) 677-3082
NPI assigned
Dec 3, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2014

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

Authorized official

Name
Judith Tanguaka, RN
Title
Staff Nurse Cardiac ICU
Phone
(248) 421-2735

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foster Care Agency 253J00000X AS630352375 MI Primary

Addresses

Primary practice location

22190 Sussex St
Oak Park, MI 48237-3509

Mailing address

22190 Sussex St
Oak Park, MI 48237-3509
Phone (248) 421-2735

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1417564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417564800000",
    "number": "1336546589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22190 SUSSEX ST",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482373509",
            "telephone_number": "248-421-2735",
            "fax_number": "248-677-3082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22190 SUSSEX ST",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482373509",
            "telephone_number": "248-421-2735",
            "fax_number": "248-677-3082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIVE STAR RESIDENTIAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-03",
        "last_updated": "2014-12-03",
        "status": "A",
        "authorized_official_last_name": "TANGUAKA",
        "authorized_official_first_name": "JUDITH",
        "authorized_official_title_or_position": "STAFF NURSE CARDIAC ICU",
        "authorized_official_telephone_number": "248-421-2735",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": "MI",
            "license": "AS630352375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2014; 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.