First Door, LLC

Primary specialty

Custodial Care FacilityTaxonomy code 311Z00000X

License

AS630369663 Issued in MI

Legal business name

FIRST DOOR, LLC

Practice address

25584 W 10 Mile Rd
Southfield, MI 48033-4826

Phone

(248) 877-8401

Fax

(313) 454-3102

NPI assigned

Oct 17, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Modeira Johnson Sr.

Title

Owner/Ceo/President

Phone

(248) 877-8401

Specialties & licenses 8

Addresses

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

{
    "created_epoch": "1476662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542067200000",
    "number": "1750832564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25584 W 10 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480334826",
            "telephone_number": "248-877-8401",
            "fax_number": "313-454-3102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25584 W 10 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480334826",
            "telephone_number": "248-877-8401",
            "fax_number": "313-454-3102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST DOOR, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-17",
        "last_updated": "2018-11-13",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "MODEIRA",
        "authorized_official_title_or_position": "OWNER/CEO/PRESIDENT",
        "authorized_official_telephone_number": "248-877-8401",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "MI",
            "license": "AS630369663",
            "primary": true
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "MI",
            "license": "AS630369663",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": "MI",
            "license": "AS630369663",
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "MI",
            "license": "AS630369663",
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "MI",
            "license": "AS630369663",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Custodial Care Facility in Southfield, MI
• Providers in Southfield, MI by specialty
• Custodial Care Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2018; 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.