Ah West Bloomfield Subtenant, LLC

Primary specialty

Home Delivered MealsTaxonomy code 332U00000X

Legal business name

AH WEST BLOOMFIELD SUBTENANT, LLC

Practice address

5859 W Maple Rd
West Bloomfield, MI 48322-2279

Phone

(248) 538-5283

Fax

(248) 538-5290

NPI assigned

Jul 8, 2020

Organization subpart

No

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

Authorized official

Name

Mallory Mock

Title

Executive Director

Phone

(248) 538-5283

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1594166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594166400000",
    "number": "1750909503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5859 W MAPLE RD",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483222279",
            "telephone_number": "248-538-5283",
            "fax_number": "248-538-5290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5859 W MAPLE RD",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483222279",
            "telephone_number": "248-538-5283",
            "fax_number": "248-538-5290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AH WEST BLOOMFIELD SUBTENANT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-08",
        "last_updated": "2020-07-08",
        "certification_date": "2020-07-08",
        "status": "A",
        "authorized_official_last_name": "MOCK",
        "authorized_official_first_name": "MALLORY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "248-538-5283"
    },
    "taxonomies": [
        {
            "code": "332U00000X",
            "taxonomy_group": "",
            "desc": "Home Delivered Meals",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in West Bloomfield, MI
• Home Delivered Meals in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2020; 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.