Organization Active NPI

Southview Afc LLC

  • Adult Care Home Facility
  • Wyoming, MI
National Provider Identifier
1376083162
Registry record updated Feb 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
License
AS410311381 Issued in MI
Legal business name
SOUTHVIEW AFC LLC
Practice address
70 56TH St SW
Wyoming, MI 49548-5739
Phone
(616) 318-1961
NPI assigned
Feb 28, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2017

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

Authorized official

Name
Debra Krajewski
Title
Licensee/Designee
Phone
(616) 318-1961

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X AS410311381 MI Primary

Addresses

Primary practice location

70 56TH St SW
Wyoming, MI 49548-5739

Mailing address

6026 Kalamazoo Ave SE
Ste 296
Grand Rapids, MI 49508-7018

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1488240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488240000000",
    "number": "1376083162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6026 KALAMAZOO AVE SE",
            "address_2": "STE 296",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495087018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 56TH ST SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495485739",
            "telephone_number": "616-318-1961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHVIEW AFC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-28",
        "last_updated": "2017-02-28",
        "status": "A",
        "authorized_official_last_name": "KRAJEWSKI",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "LICENSEE/DESIGNEE",
        "authorized_official_telephone_number": "616-318-1961"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "MI",
            "license": "AS410311381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyoming, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2017; 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.