Heavenly Comfort Afc LLC

Primary specialty

Mental Illness Intermediate Care FacilityTaxonomy code 310500000X

License

AS820316694 Issued in MI

Legal business name

HEAVENLY COMFORT AFC LLC

Practice address

19103 Woodmont St
Harper Woods, MI 48225-1319

Phone

(313) 434-5810

NPI assigned

Sep 6, 2012

Organization subpart

No

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

Authorized official

Name

Mrs. Sheana Louise Waldburg

Title

Owner

Phone

(313) 434-5810

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1346889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346889600000",
    "number": "1679822431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19103 WOODMONT ST",
            "city": "HARPER WOODS",
            "state": "MI",
            "postal_code": "482251319",
            "telephone_number": "313-434-5810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19103 WOODMONT ST",
            "city": "HARPER WOODS",
            "state": "MI",
            "postal_code": "482251319",
            "telephone_number": "313-434-5810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEAVENLY COMFORT AFC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-06",
        "last_updated": "2012-09-06",
        "status": "A",
        "authorized_official_last_name": "WALDBURG",
        "authorized_official_first_name": "SHEANA",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-434-5810",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310500000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Mental Illness",
            "state": "MI",
            "license": "AS820316694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Illness Intermediate Care Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 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.