Specially Made Co. LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

SPECIALLY MADE CO. LLC

Practice address

845 E Summerfield Glen Cir
Ann Arbor, MI 48103-9161

Phone

(248) 790-4135

NPI assigned

Aug 28, 2019

Organization subpart

No

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

Authorized official

Name

Kristin Kill

Title

Pres/Ceo

Phone

(248) 790-4135

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1566950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566950400000",
    "number": "1760030183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7631 N DIXBORO RD",
            "city": "SOUTH LYON",
            "state": "MI",
            "postal_code": "481787008",
            "telephone_number": "248-790-4135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 E SUMMERFIELD GLEN CIR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481039161",
            "telephone_number": "248-790-4135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALLY MADE CO. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-28",
        "last_updated": "2019-08-28",
        "status": "A",
        "authorized_official_last_name": "KILL",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_title_or_position": "PRES/CEO",
        "authorized_official_telephone_number": "248-790-4135"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Austin John Spaulding, NP
• Glenn Jefferson Spaulding, LMSW
• Lisa Spaulding, LLMSW
• Christopher Chauncey Spears, MD
• Kaitlyn Spears, PHARM.D.
• Aimee Leyton Speck, MD
• Karen Elizabeth Speck, M.D.
• Nicole Marie Speck, NP
• Nathan Speckhart
• Tara Breanne Spector, M.D.

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.