Lively Residential Paradise

Primary specialty

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

Legal business name

LIVELY RESIDENTIAL PARADISE

Practice address

16558 Mansfield St
Detroit, MI 48235-3631

Phone

(313) 229-6215

NPI assigned

Oct 30, 2024

Organization subpart

No

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

Authorized official

Name

Santanna Lively

Title

Owner

Phone

(313) 340-2225

Specialties & licenses 1

Addresses

Other names 1

• Lively Facilitated Living Doing business as

Tax ID family

Lively Facilitated Living2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Lively Residential Paradise

  • Home Health Agency
  • Detroit, MI
  • NPI 1154249902
  NPD tax ID

Locations

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

{
    "created_epoch": "1730246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730246400000",
    "number": "1760204697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25900 GREENFIELD RD STE 350",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482371297",
            "telephone_number": "313-229-6215",
            "fax_number": "404-900-3987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16558 MANSFIELD ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482353631",
            "telephone_number": "313-229-6215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVELY RESIDENTIAL PARADISE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-30",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A",
        "authorized_official_last_name": "LIVELY",
        "authorized_official_first_name": "SANTANNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-340-2225"
    },
    "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": [
        {
            "organization_name": "Lively Facilitated Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Xiaosu Liu
• Liv Well Urgent Care PLLC
• Live Life Home Health Care LLC
• Live Long Home Care
• Lively Residential Paradise
• Shakeita La'Neice Lively, BSW
• Livernois Dental Care PLLC
• Livernois Express Pharmacy
• Livernois Family Medical SVC
• Livernois Family Pharmacy

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Detroit, MI
• Providers in Detroit, 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 Oct 30, 2024; 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.