Organization Active NPI

IHS Acquisition No. 111, Inc.

  • Skilled Nursing Facility
  • Clarkston, MI
National Provider Identifier
1508953787
Registry record updated Dec 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
IHS ACQUISITION NO. 111, INC.
Practice address
4800 Clintonville Rd
Clarkston, MI 48346-4297
Phone
(248) 674-0903
Fax
(248) 674-3431
NPI assigned
Oct 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2007

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

Authorized official

Name
Maggie Canny
Title
President
Phone
(248) 674-0903

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

4800 Clintonville Rd
Clarkston, MI 48346-4297

Mailing address

930 Ridgebrook Rd
Sparks, MD 21152-9390
Phone (410) 773-1000

Other identifiers 1

IdentifierTypeStateIssuer
4163588MedicaidMI

Other names 1

  • Clarkston Specialty Healthcare Center Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1160179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198108800000",
    "number": "1508953787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 RIDGEBROOK RD",
            "city": "SPARKS",
            "state": "MD",
            "postal_code": "211529390",
            "telephone_number": "410-773-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 CLINTONVILLE RD",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483464297",
            "telephone_number": "248-674-0903",
            "fax_number": "248-674-3431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IHS ACQUISITION NO. 111, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-07",
        "last_updated": "2007-12-20",
        "status": "A",
        "authorized_official_last_name": "CANNY",
        "authorized_official_first_name": "MAGGIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-674-0903"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4163588",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clarkston Specialty Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clarkston, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2007; 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.