Active NPI
IHS Acquisition No. 111, Inc.
- Skilled Nursing Facility
- Clarkston, MI
National Provider Identifier
1508953787
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4163588 | Medicaid | MI |
Other names 1
- Clarkston Specialty Healthcare Center
National Provider Directory
National Provider DirectoryNPI 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.