Blessed Home Afc Services, LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

AL 110238445 Issued in MI

Legal business name

BLESSED HOME AFC SERVICES, LLC

Practice address

1217 Stateline Rd
Niles, MI 49120-4729

Phone

(269) 684-2668

Fax

(269) 683-8986

NPI assigned

Jun 24, 2013

Last updated

Jun 24, 2013By 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

Michael Adeniyi, PHD, ND

Title

Administrator

Phone

(269) 684-2668

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1372032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372032000000",
    "number": "1346689221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1217 STATELINE RD",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491204729",
            "telephone_number": "269-684-2668",
            "fax_number": "269-683-8986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1217 STATELINE RD",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491204729",
            "telephone_number": "269-684-2668",
            "fax_number": "269-683-8986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLESSED HOME AFC SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-24",
        "last_updated": "2013-06-24",
        "status": "A",
        "authorized_official_last_name": "ADENIYI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "269-684-2668",
        "authorized_official_credential": "PHD, ND"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "MI",
            "license": "AL 110238445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2013; 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.