The Firecracker Foundation

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

THE FIRECRACKER FOUNDATION

Practice address

2450 Delhi Commerce Dr Ste 9
Holt, MI 48842-2193

Phone

(517) 242-5467

NPI assigned

Jul 21, 2017

Organization subpart

No

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

Authorized official

Name

Tashmica Torok

Title

Executive Director

Phone

(517) 242-5467

Specialties & licenses 5

Addresses

Locations

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

{
    "created_epoch": "1500595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1669995635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 DELHI COMMERCE DR STE 9",
            "city": "HOLT",
            "state": "MI",
            "postal_code": "488422193",
            "telephone_number": "517-242-5467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 DELHI COMMERCE DR STE 9",
            "city": "HOLT",
            "state": "MI",
            "postal_code": "488422193",
            "telephone_number": "517-242-5467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE FIRECRACKER FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-21",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "TOROK",
        "authorized_official_first_name": "TASHMICA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "517-242-5467"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan S Maples DDS, Msba, PLLC
• T3-Trauma to Triumph LLC
• Matthew Myles Telemaque
• Stephen G Tepastte, MD
• Terence E McHugh DDS PLC
• Winston Thomas
• Kacie Marie Thomason, LLPC
• Pamela Thompson, DO
• Kristina Elizabeth Tiernan, RDN
• Marybeth Timotiwu

• Adolescent and Children Mental Health Clinic/Center in Holt, MI
• Providers in Holt, MI by specialty
• Adolescent and Children Mental Health Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.