Burnett Afc

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

AM250067081 Issued in MI

Legal business name

BURNETT AFC

Practice address

2181 Kenneth St
Burton, MI 48529-1358

Phone

(810) 743-6291

Fax

(810) 743-1579

NPI assigned

Oct 7, 2008

Organization subpart

No

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

Authorized official

Name

Dana M Burnett

Title

Owner/Licensee

Phone

(810) 743-6291

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1223337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223337600000",
    "number": "1639320708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2181 KENNETH ST",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485291358",
            "telephone_number": "810-743-6291",
            "fax_number": "810-743-1579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2181 KENNETH ST",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485291358",
            "telephone_number": "810-743-6291",
            "fax_number": "810-743-1579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BURNETT AFC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-07",
        "last_updated": "2008-10-07",
        "status": "A",
        "authorized_official_last_name": "BURNETT",
        "authorized_official_first_name": "DANA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/LICENSEE",
        "authorized_official_telephone_number": "810-743-6291"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "MI",
            "license": "AM250067081",
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "MI",
            "license": "AM250067081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5294486",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tabitha Farley Bucknam, M.S.
• Chelsey Budlong
• Jeffery Brian Bundy, D.D.S.
• Parker Jay Bundy, DDS
• Lauren Burkhardt
• Burnett Afc LLC
• Jason M Burns, DPT
• Burton Advance Dental, P.C.
• Burton Dental Center
• Burton Dental Center

• All providers in Burton, MI
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2008; 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.