Newcastle Afc LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

AS410322595 Issued in MI

Legal business name

NEWCASTLE AFC LLC

Practice address

3704 Newcastle Dr SE
Grand Rapids, MI 49508-5500

Phone

(616) 608-6985

NPI assigned

Feb 14, 2017

Organization subpart

No

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

Authorized official

Name

Nadine Carlson

Title

Owner

Phone

(248) 342-2698

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1487030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487030400000",
    "number": "1669911392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 HODENPYL RD SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495062060",
            "telephone_number": "248-342-2698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3704 NEWCASTLE DR SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495085500",
            "telephone_number": "616-608-6985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEWCASTLE AFC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-14",
        "last_updated": "2017-02-14",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "NADINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-342-2698"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "MI",
            "license": "AS410322595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin Gerritt Newberg
• Kimberlee Joy Newberg, RDH
• Daniel Scott Newberger, LLMSW
• Chad Newbill
• Jonathan Newby
• Christopher Edgar Newell, PHARM. D
• Dawn Newell
• Hannah Newell, DPT
• Julia Marie Newell
• Samantha Paige Newell

• Adult Care Home Facility in Grand Rapids, MI
• Providers in Grand Rapids, 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 14, 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.