Boys to Men Group Home, LLC

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

Legal business name

BOYS TO MEN GROUP HOME, LLC

Practice address

6025 Litchfield LN
Kalamazoo, MI 49009-9128

Phone

(269) 254-8444

NPI assigned

Sep 18, 2012

Last updated

Sep 18, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Anthony Poplar

Title

Co-Owner

Phone

(269) 998-9343

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1347926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347926400000",
    "number": "1659621597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6025 LITCHFIELD LN",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490099128",
            "telephone_number": "269-254-8444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6025 LITCHFIELD LN",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490099128",
            "telephone_number": "269-254-8444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOYS TO MEN GROUP HOME, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-18",
        "last_updated": "2012-09-18",
        "status": "A",
        "authorized_official_last_name": "POPLAR",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "269-998-9343",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Noah Boyd
• Sade Boyd
• Raven Boykins, B.S.
• Trinity Boykins
• Laura Boylan
• Teagan Marie Bozyk, PA-C
• Christopher Brackshaw, D.O
• Devinne Denai Bradford
• James R Bradford, MD
• Kaitlyn Bradham

• Emotionally Disturbed Childrens' Residential Treatment Facility in Kalamazoo, MI
• Providers in Kalamazoo, MI by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2012; 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.