Little Rock Baptist Charity Care Center, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

834930 Issued in MI

Legal business name

LITTLE ROCK BAPTIST CHARITY CARE CENTER, INC.

Practice address

9146 Woodward Avenue
Detroit, MI 48202-1612

Phone

(313) 875-1263

Fax

(313) 875-5842

NPI assigned

Sep 7, 2005

Organization subpart

No

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

Authorized official

Name

Deepak Bhalla

Title

Exec. V.P. Operations

Phone

(313) 483-3905

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Lakeshore Healthcare Skilled Nursing & Specialty Care - Woodward Campu Doing business as

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

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350432000000",
    "number": "1467446385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9146 WOODWARD AVENUE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482021612",
            "telephone_number": "313-875-1263",
            "fax_number": "313-875-5842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9146 WOODWARD AVENUE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482021612",
            "telephone_number": "313-875-1263",
            "fax_number": "313-875-5842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LITTLE ROCK BAPTIST CHARITY CARE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-07",
        "last_updated": "2012-10-17",
        "status": "A",
        "authorized_official_last_name": "BHALLA",
        "authorized_official_first_name": "DEEPAK",
        "authorized_official_title_or_position": "EXEC. V.P. OPERATIONS",
        "authorized_official_telephone_number": "313-483-3905"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MI",
            "license": "834930",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2151069",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeshore Healthcare Skilled Nursing & Specialty Care - Woodward Campu",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ryan Walter Lithgow, PHYSICAL THERAPIST
• Melody Stashia Litkouhi, LMSW
• Luis Litonjua, DMD, DDS
• Little Magic Therapies, LLC
• Little Mighty Clouds of Joy, LLC
• Bryan E. Little, M.D.
• Chaunice Evonne Little
• Harmony Grace Little
• Malinda Little
• Margaret Little, LMSW

• Skilled Nursing Facility in Detroit, MI
• Providers in Detroit, MI by specialty
• Skilled Nursing Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2012; 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.