Bonner House, Inc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

BONNER HOUSE, INC

Practice address

13892 Collingham Dr
Detroit, MI 48205-1213

Phone

(248) 804-1372

NPI assigned

May 13, 2024

Organization subpart

No

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

Authorized official

Name

Mrs. Leeaundra Childress, RN

Title

Chief Executive Officer

Phone

(248) 804-1372

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1715558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715558400000",
    "number": "1598514630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "468 STRAIT LN",
            "city": "WAXAHACHIE",
            "state": "TX",
            "postal_code": "751650136",
            "telephone_number": "248-804-1372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13892 COLLINGHAM DR",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482051213",
            "telephone_number": "248-804-1372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BONNER HOUSE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-13",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A",
        "authorized_official_last_name": "CHILDRESS",
        "authorized_official_first_name": "LEEAUNDRA",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "248-804-1372",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marilyn Denice Bonkowski
• Tyler John Bonkowski, DO
• Ramona Denise Bonner-McCain, MSW
• Amber Michele Bonner
• Christal Bonner
• Eraina Allysse Bonner
• John Bonnett, MD

• Community/Behavioral Health Agency in Detroit, MI
• Providers in Detroit, MI by specialty
• Community/Behavioral Health Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2024; 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.