Karen Frederick LLC

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

License

AS820367993 Issued in MI

Legal business name

KAREN FREDERICK LLC

Practice address

5781 Beaconsfield St
Detroit, MI 48224-3157

Phone

(313) 469-5946

NPI assigned

May 11, 2015

Organization subpart

No

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

Authorized official

Name

Ms. Jazmine M Ford

Title

Owner

Phone

(313) 469-5946

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1431302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431302400000",
    "number": "1407234586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5796 BEACONSFIELD ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482243158",
            "telephone_number": "313-469-5946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5781 BEACONSFIELD ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482243157",
            "telephone_number": "313-469-5946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAREN FREDERICK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-11",
        "last_updated": "2015-05-11",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "JAZMINE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-469-5946",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "MI",
            "license": "AS820367993",
            "primary": true
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "MI",
            "license": "AS820367993",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Detroit, MI
• Providers in Detroit, MI by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2015; 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.