Southwest Afc LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

AM410285333 Issued in MI

Legal business name

SOUTHWEST AFC LLC

Practice address

212 56TH St SW
Wyoming, MI 49548-5743

Phone

(616) 318-1961

NPI assigned

Feb 28, 2017

Organization subpart

No

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

Authorized official

Name

Debra Krajewski

Title

Licensee/Designee

Phone

(616) 318-1961

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1488240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488240000000",
    "number": "1619417409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6026 KALAMAZOO AVE SE",
            "address_2": "STE 296",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495087018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 56TH ST SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495485743",
            "telephone_number": "616-318-1961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST AFC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-28",
        "last_updated": "2017-02-28",
        "status": "A",
        "authorized_official_last_name": "KRAJEWSKI",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "LICENSEE/DESIGNEE",
        "authorized_official_telephone_number": "616-318-1961"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "MI",
            "license": "AM410285333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Care Home Facility in Wyoming, MI
• Providers in Wyoming, 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 28, 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.