Organization Active NPI

Professional Preventive Restoration & Consultant Services

  • Community/Behavioral Health Agency
  • Livonia, MI
National Provider Identifier
1407245228
Registry record updated Jan 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
PROFESSIONAL PREVENTIVE RESTORATION & CONSULTANT SERVICES
Practice address
17314 Farmington Rd
Livonia, MI 48152-3158
Phone
(734) 421-7772
NPI assigned
Jan 16, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2015

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

Authorized official

Name
Odeather HillNPI 1730265018
Title
Ceo
Phone
(313) 247-2327

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

17314 Farmington Rd
Livonia, MI 48152-3158

Mailing address

17314 Farmington Rd
Livonia, MI 48152-3158

National Provider Directory

National Provider Directory

Locations

17314 Farmington Rd
Livonia, MI 48152
Phone (734) 421-7772

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1421366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421366400000",
    "number": "1407245228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17314 FARMINGTON RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481523158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17314 FARMINGTON RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481523158",
            "telephone_number": "734-421-7772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL PREVENTIVE RESTORATION & CONSULTANT SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-16",
        "last_updated": "2015-01-16",
        "status": "A",
        "authorized_official_last_name": "HILL",
        "authorized_official_first_name": "ODEATHER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "313-247-2327"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 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.