Ah Lakeside I Ldha LLC

Primary specialty

Home Delivered MealsTaxonomy code 332U00000X

Legal business name

AH LAKESIDE I LDHA LLC

Doing business as

Baldwin House Lakeside I

Practice address

15731 19 Mile Rd
Clinton Township, MI 48038-6315

Phone

(586) 263-0081

Fax

(586) 412-1672

NPI assigned

May 14, 2020

Organization subpart

No

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

Authorized official

Name

Aubrey Brohl

Title

Executive Director

Phone

(586) 263-0081

Specialties & licenses 2

Addresses

Other names 1

• Baldwin House Lakeside I Doing business as

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

{
    "created_epoch": "1589414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626307200000",
    "number": "1386266245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15731 19 MILE RD",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480386315",
            "telephone_number": "586-263-0081",
            "fax_number": "586-412-1672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15731 19 MILE RD",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480386315",
            "telephone_number": "586-263-0081",
            "fax_number": "586-412-1672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AH LAKESIDE I LDHA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-14",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A",
        "authorized_official_last_name": "BROHL",
        "authorized_official_first_name": "AUBREY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "586-263-0081"
    },
    "taxonomies": [
        {
            "code": "332U00000X",
            "taxonomy_group": "",
            "desc": "Home Delivered Meals",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baldwin House Lakeside I",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kaliopi Kelly Agas
• Olivia Agnetti
• Carol S Agnew, LMFT
• Eugersa Agolli, DO
• Kimberly Aguinaga, L.B.S.W.
• Ah Lakeside II Ldha LLC (Baldwin House Lakeside II)
• Sumbal Ahmad
• Nadia Ahmed, DO
• Nadim Ahmed
• Tarek Ahmed

• Home Delivered Meals in Clinton Township, MI
• Providers in Clinton Township, MI by specialty
• Home Delivered Meals in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2021; 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.