My Home Away From Home Residential & Physical Therapy

Primary specialty

Physical Disabilities Residential Treatment FacilityTaxonomy code 320700000X

License

E4609Q Issued in MI

Legal business name

MY HOME AWAY FROM HOME RESIDENTIAL & PHYSICAL THERAPY

Practice address

1155 W McNichols Rd Apt 106
Highland Park, MI 48203-2514

Phone

(313) 989-7092

NPI assigned

Jun 9, 2014

Last updated

Jun 9, 2014By 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

Miss Star Billy Schumake

Title

Owner/C.E.O

Phone

(313) 989-7092

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1402272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402272000000",
    "number": "1689087504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 W MCNICHOLS RD APT 106",
            "city": "HIGHLAND PARK",
            "state": "MI",
            "postal_code": "482032514",
            "telephone_number": "313-989-7092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 W MCNICHOLS RD APT 106",
            "city": "HIGHLAND PARK",
            "state": "MI",
            "postal_code": "482032514",
            "telephone_number": "313-989-7092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY HOME AWAY FROM HOME RESIDENTIAL & PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-09",
        "last_updated": "2014-06-09",
        "status": "A",
        "authorized_official_last_name": "SCHUMAKE",
        "authorized_official_first_name": "STAR",
        "authorized_official_middle_name": "BILLY",
        "authorized_official_title_or_position": "OWNER/C.E.O",
        "authorized_official_telephone_number": "313-989-7092",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": "MI",
            "license": "E4609Q",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erica Moore
• Priest Morgan
• Shontae Rene Morris
• Hamedah Mosed, NP
• Sierra Mosley, RN
• My Sisters Keypers
• Shawanda Myers
• Sunitha Nambiar, M.D.
• Michael Lewis Napoleon
• Kolsuma Nessa

• Physical Disabilities Residential Treatment Facility in Highland Park, MI
• Providers in Highland Park, MI by specialty
• Physical Disabilities Residential Treatment Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2014; 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.