Advance Healing and Integrative Services LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

ADVANCE HEALING AND INTEGRATIVE SERVICES LLC

Practice address

12900 W 9 Mile Rd
Oak Park, MI 48237-2990

Phone

(480) 444-8184

NPI assigned

Dec 7, 2021

Organization subpart

No

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

Authorized official

Name

Chenaull Jordan, APNNPI 1972892305

Title

Owner

Phone

(480) 444-8184

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI, AZ2 enrollments

Enrollment records 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Chenaull Van Jordan, N.P.

  • Family Nurse Practitioner
  • Troy, MI
  • NPI 1972892305

  AZ, MI, Psychiatric/Mental Health

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1638835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638835200000",
    "number": "1619635570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12900 W 9 MILE RD",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482372990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12900 W 9 MILE RD",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482372990",
            "telephone_number": "480-444-8184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCE HEALING AND INTEGRATIVE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-07",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "CHENAULL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-444-8184",
        "authorized_official_credential": "APN"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Active Plus Physical Therapy II Inc
• Acure Home Care, Inc.
• Acyss Home Health Services, Inc.
• Tracey Adams
• Advance Family Services
• Advance Laser Therapy PLC
• Advance Medical Equipment & Supply Inc.
• Advanced Care Services, Inc.
• Advanced Medical Services PLLC
• Advanced Seniors Healthcare Group, Inc

• All providers in Oak Park, MI
• Psychiatric/Mental Health Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.