Great Living Foster Care

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

License

AF110317417 Issued in MI

Legal business name

GREAT LIVING FOSTER CARE

Practice address

8973 Pioneer CT
Berrien Springs, MI 49103-1700

Phone

(269) 815-2087

Fax

(269) 815-5064

NPI assigned

May 21, 2014

Organization subpart

No

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

Authorized official

Name

Bergeline Florvilus, RN

Title

Manager

Phone

(269) 815-2087

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1400630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400630400000",
    "number": "1487066734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8973 PIONEER CT",
            "city": "BERRIEN SPRINGS",
            "state": "MI",
            "postal_code": "491031700",
            "telephone_number": "269-815-2087",
            "fax_number": "269-815-5064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8973 PIONEER CT",
            "city": "BERRIEN SPRINGS",
            "state": "MI",
            "postal_code": "491031700",
            "telephone_number": "269-815-2087",
            "fax_number": "269-815-5064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LIVING FOSTER CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-21",
        "last_updated": "2014-05-21",
        "status": "A",
        "authorized_official_last_name": "FLORVILUS",
        "authorized_official_first_name": "BERGELINE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "269-815-2087",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "MI",
            "license": "AF110317417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Illness Community Based Residential Treatment Facility in Berrien Springs, MI
• Providers in Berrien Springs, MI by specialty
• Mental Illness Community Based Residential Treatment Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2014; 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.