Maple Ridge Adult Foster Care Home, LLC

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

License

AM480008975 Issued in MI

Legal business name

MAPLE RIDGE ADULT FOSTER CARE HOME, LLC

Practice address

2979 County Road 413
MC Millan, MI 49853-9357

Phone

(906) 586-3019

Fax

(906) 586-6608

NPI assigned

Aug 31, 2010

Last updated

Aug 31, 2010By 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

Ms. Melissa Ann Hinkson

Title

President

Phone

(906) 586-3019

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1283212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283212800000",
    "number": "1730496597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2979 COUNTY ROAD 413",
            "city": "MC MILLAN",
            "state": "MI",
            "postal_code": "498539357",
            "telephone_number": "906-586-3019",
            "fax_number": "906-586-6608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2979 COUNTY ROAD 413",
            "city": "MC MILLAN",
            "state": "MI",
            "postal_code": "498539357",
            "telephone_number": "906-586-3019",
            "fax_number": "906-586-6608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLE RIDGE ADULT FOSTER CARE HOME, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-31",
        "last_updated": "2010-08-31",
        "status": "A",
        "authorized_official_last_name": "HINKSON",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "906-586-3019",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "MI",
            "license": "AM480008975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy Fillmore, LMSW
• Trilliumwood Counseling Services

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in McMillan, MI
• Providers in McMillan, MI by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2010; 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.