My Place Afc

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Legal business name

MY PLACE AFC

Practice address

21415 Sherman Ave
Southfield, MI 48033-4388

Phone

(313) 510-2879

Fax

(248) 559-5692

NPI assigned

Apr 13, 2018

Organization subpart

No

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

Authorized official

Name

Mrs. Samantha M Evans

Title

President

Phone

(313) 510-2879

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1523577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523577600000",
    "number": "1760979959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15565 NORTHLAND DR E STE 901",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480755331",
            "telephone_number": "248-559-5683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21415 SHERMAN AVE",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480334388",
            "telephone_number": "313-510-2879",
            "fax_number": "248-559-5692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY PLACE AFC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-13",
        "last_updated": "2018-04-13",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-510-2879",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• MWD Enterprises LLC (Homewatch CareGivers of Southfield)
• My Advocates LLC
• My City Home Help Services
• My Family Dental Novi PLLC
• My Kids Doc-Southfield
• My Visiting Physicians PC
• Hannah Myers
• Larissa Sophie Myers
• Stacy Myers
• Myndhorizon Southfield/Detriot PLLC (Mynd Horizons PLC)

• Community Health Worker in Southfield, MI
• Providers in Southfield, MI by specialty
• Community Health Worker in Michigan

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