Tenisha's Adult Foster Care Home

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

TENISHA'S ADULT FOSTER CARE HOME

Practice address

73 Fairgrove St
Pontiac, MI 48342-2309

Phone

(248) 390-8128

NPI assigned

Sep 12, 2007

Last updated

Sep 12, 2007By 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

Mrs. Tenisha Ann Mullen

Title

Home Provider

Phone

(248) 390-8128

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1189555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189555200000",
    "number": "1346435302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73 FAIRGROVE ST",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483422309",
            "telephone_number": "248-390-8128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73 FAIRGROVE ST",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483422309",
            "telephone_number": "248-390-8128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TENISHA'S ADULT FOSTER CARE HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-12",
        "last_updated": "2007-09-12",
        "status": "A",
        "authorized_official_last_name": "MULLEN",
        "authorized_official_first_name": "TENISHA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "HOME PROVIDER",
        "authorized_official_telephone_number": "12483908128",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Care Home Facility in Pontiac, MI
• Providers in Pontiac, MI by specialty
• Adult Care Home Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2007; 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.