NPIMap

Organization Active NPI

Bertram'S Manor LLC

  • Mental Illness Community Based Residential Treatment Facility
  • Flint, MI
National Provider Identifier
1700037082
Registry record updated Oct 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
AM250289405 Issued in MI
Legal business name
BERTRAM'S MANOR LLC
Practice address
1202 Church St
Flint, MI 48502-1015
Phone
(810) 238-1430
Fax
(810) 238-1447
NPI assigned
Oct 6, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2008

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

Authorized official

Name
Nicholas D Burnett
Title
Owner/Administrator
Phone
(810) 238-1430

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X AM250289405 MI Primary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X AM250289405 MI

Addresses

Primary practice location

1202 Church St
Flint, MI 48502-1015

Mailing address

1202 Church St
Flint, MI 48502-1015
Phone (810) 238-1430

National Provider Directory

National Provider Directory
Tax ID family
Bertram'S Manor LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1223251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223251200000",
    "number": "1700037082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 CHURCH ST",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485021015",
            "telephone_number": "810-238-1430",
            "fax_number": "810-238-1447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 CHURCH ST",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485021015",
            "telephone_number": "810-238-1430",
            "fax_number": "810-238-1447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERTRAM'S MANOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-06",
        "last_updated": "2008-10-06",
        "status": "A",
        "authorized_official_last_name": "BURNETT",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "810-238-1430"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "MI",
            "license": "AM250289405",
            "primary": true
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "MI",
            "license": "AM250289405",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2008; 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.