NPIMap

Organization Active NPI

Fountain of Love Assisted Living Sevices Inc

  • Adult Day Care Clinic/Center
  • Oak Park, MI
National Provider Identifier
1497160477
Registry record updated Apr 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
Legal business name
FOUNTAIN OF LOVE ASSISTED LIVING SEVICES INC
Practice address
21820 Beverly St
Oak Park, MI 48237-2503
Phone
(248) 796-7112
Fax
(248) 808-6052
NPI assigned
Jun 27, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2016

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

Authorized official

Name
Shanell ClarkNPI 1972958106
Title
President
Phone
(248) 796-8004

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Day Care Clinic/Center 261QA0600X Primary
Non-emergency Medical Transport (VAN) 343900000X

Addresses

Primary practice location

21820 Beverly St
Oak Park, MI 48237-2503

Mailing address

21820 Beverly St
Oak Park, MI 48237-2503
Phone (248) 796-7112

Other names 1

  • 4-Wings Transportation Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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": "1403827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461196800000",
    "number": "1497160477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21820 BEVERLY ST",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482372503",
            "telephone_number": "248-796-7112",
            "fax_number": "248-808-6052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21820 BEVERLY ST",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482372503",
            "telephone_number": "248-796-7112",
            "fax_number": "248-808-6052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNTAIN OF LOVE ASSISTED LIVING SEVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-27",
        "last_updated": "2016-04-21",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "SHANELL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-796-8004"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "4-Wings Transportation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oak Park, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2016; 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.