Full Life Independence, LLC

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Legal business name

FULL LIFE INDEPENDENCE, LLC

Practice address

1019 E Summerfield Glen Cir
Ann Arbor, MI 48103-9163

Phone

(734) 741-1227

Fax

(734) 369-2419

NPI assigned

Nov 19, 2018

Last updated

Nov 19, 2018By the provider in NPPES

Organization subpart

Yes

Parent organization

WASHTENAW COUNTY CSTSAs reported in NPPES

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

Authorized official

Name

Ms. Rochelle Lynn StolerNPI 1417426420

Title

Assistant Director

Phone

(734) 741-1227

Specialties & licenses 1

Addresses

Other names 1

• Washtenaw Community Mental Health Other name

Part of

County of Washtenaw

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Washtenaw County CSTS

  • Case Management Agency
  • Ypsilanti, MI
  • NPI 1851703805
  NPPES parent name

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Rochelle Lynn Stoler

  • Community Health Worker
  • Ann Arbor, MI
  • NPI 1417426420
  NPD Authorized official
• Maureen Elaine Forrest, M.D.

  • Diagnostic Radiology Physician
  • Ann Arbor, MI
  • NPI 1760650451
  NPD

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

{
    "created_epoch": "1542585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542585600000",
    "number": "1477022481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3893 S MICHAEL RD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481039345",
            "telephone_number": "734-665-7303",
            "fax_number": "734-369-2419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1019 E SUMMERFIELD GLEN CIR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481039163",
            "telephone_number": "734-741-1227",
            "fax_number": "734-369-2419"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "929 E Summerfield Glen Cir",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481039162",
            "country_code": "US",
            "telephone_number": "734-645-3877",
            "fax_number": "734-369-2419",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FULL LIFE INDEPENDENCE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WASHTENAW COUNTY CSTS",
        "enumeration_date": "2018-11-19",
        "last_updated": "2018-11-19",
        "status": "A",
        "authorized_official_last_name": "STOLER",
        "authorized_official_first_name": "ROCHELLE",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "ASSISTANT DIRECTOR",
        "authorized_official_telephone_number": "734-741-1227",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Washtenaw Community Mental Health",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Yosuke Fujioka, MD
• Shinichi Fukuhara, M.D.
• Alyssa Lee Fulayter
• Rebecca Marguerite Fulesi, PA-C
• David James Fulkerson, MSW
• Genaro Dagan Fullano, ATC
• Douglas R Fullen, MD
• Emily Fuller-Lechton
• Duncan David Frederick Fuller, MD
• Katherine Angel Fuller

• Community Health Worker in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Community Health Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2018; 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.