NPIMap

Organization Active NPI

Kourouma Services LLC

  • Public Health or Welfare Agency
  • Detroit, MI
National Provider Identifier
1780996926
Registry record updated Jul 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
License
4704258152 Issued in MI
Legal business name
KOUROUMA SERVICES LLC
Practice address
13560 E McNichols Rd
Detroit, MI 48205-3426
Phone
(313) 402-7812
NPI assigned
Jul 3, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2012

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

Authorized official

Name
Mrs. Chantelle Morrison-Kourouma, RN, M.EDNPI 1316273030
Title
President
Phone
(313) 402-7812

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X 4704258152 MI
Nursing Care Agency 251J00000X 4704258152 MI
Public Health or Welfare Agency 251K00000X 4704258152 MI Primary
Community/Behavioral Health Agency 251S00000X 4704258152 MI

Addresses

Primary practice location

13560 E McNichols Rd
Detroit, MI 48205-3426

Mailing address

PO Box 8235
Eastpointe, MI 48021-8235
Phone (313) 402-7812

Other identifiers 2

IdentifierTypeStateIssuer
2249265MedicaidMI
1316273030MedicaidMI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1278115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341878400000",
    "number": "1780996926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8235",
            "city": "EASTPOINTE",
            "state": "MI",
            "postal_code": "480218235",
            "telephone_number": "313-402-7812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13560 E MCNICHOLS RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482053426",
            "telephone_number": "313-402-7812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOUROUMA SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-03",
        "last_updated": "2012-07-10",
        "status": "A",
        "authorized_official_last_name": "MORRISON-KOUROUMA",
        "authorized_official_first_name": "CHANTELLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-402-7812",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN, M.ED"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "MI",
            "license": "4704258152",
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "MI",
            "license": "4704258152",
            "primary": false
        },
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "MI",
            "license": "4704258152",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MI",
            "license": "4704258152",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2249265",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1316273030",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2012; 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.