Amant Afc

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

AF410379501 Issued in MI

Legal business name

AMANT AFC

Practice address

1018 Widdicomb Ave NW
Grand Rapids, MI 49504-4130

Phone

(616) 228-4624

Fax

(616) 588-6048

NPI assigned

Feb 17, 2017

Last updated

Feb 17, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ashley B Deboer

Title

Owner

Phone

(616) 818-2472

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1487289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487289600000",
    "number": "1508305921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1018 WIDDICOMB AVE NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495044130",
            "telephone_number": "616-228-4624",
            "fax_number": "616-588-6048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1018 WIDDICOMB AVE NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495044130",
            "telephone_number": "616-228-4624",
            "fax_number": "616-588-6048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMANT AFC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-17",
        "last_updated": "2017-02-17",
        "status": "A",
        "authorized_official_last_name": "DEBOER",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-818-2472"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "MI",
            "license": "AF410379501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Care Home Facility in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Adult Care Home Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2017; 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.