Hampton Manor of Shelby LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

HAMPTON MANOR OF SHELBY LLC

Practice address

51831 Van Dyke Ave
Shelby Township, MI 48316-4454

Phone

(586) 333-4940

NPI assigned

Dec 3, 2019

Last updated

Dec 3, 2019By 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. Douglas Edward Jr.

Title

Executive Director

Phone

(248) 930-7875

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1575331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575331200000",
    "number": "1699312298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51831 VAN DYKE AVE",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483164454",
            "telephone_number": "586-333-4940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51831 VAN DYKE AVE",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483164454",
            "telephone_number": "586-333-4940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAMPTON MANOR OF SHELBY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-03",
        "last_updated": "2019-12-03",
        "status": "A",
        "authorized_official_last_name": "EDWARD",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "248-930-7875",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MICHIGAN HFA LICENSE",
            "identifier": "AH500387033",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kenyetta Marie Hall-McPherson
• Lisa Marie Hall, M.D.
• Jessica Lynne Halverson, DPT
• Kimberly Hamilton
• Theodore G. Hammond, O.D.
• Rand Hana
• Amy Hanes, PSYD
• Katelyn Haney
• Manar Maan Hannakachl
• Hano Unlimited LLC

• Assisted Living Facility in Shelby Township, MI
• Providers in Shelby Township, MI by specialty
• Assisted Living Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2019; 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.