McMahan Adult Foster Care

Primary specialty

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

License

AS250285536 Issued in MI

Legal business name

MCMAHAN ADULT FOSTER CARE

Practice address

1478 E Buder Ave
Burton, MI 48529-1606

Phone

(810) 875-9681

Fax

(810) 875-9681

NPI assigned

Oct 9, 2008

Organization subpart

No

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

Authorized official

Name

Tracy Renee McMahan

Title

Owner

Phone

(810) 875-9681

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1223510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223510400000",
    "number": "1790936607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1478 E BUDER AVE",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485291606",
            "telephone_number": "810-875-9681",
            "fax_number": "810-875-9681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1478 E BUDER AVE",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485291606",
            "telephone_number": "810-875-9681",
            "fax_number": "810-875-9681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCMAHAN ADULT FOSTER CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-09",
        "last_updated": "2008-10-09",
        "status": "A",
        "authorized_official_last_name": "MCMAHAN",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "810-875-9681"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "AS250285536",
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "MI",
            "license": "AS250285536",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AS250285536",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Timothy G McNally, DO
• Francesca Lynn McNeil
• Vicente M Medalle, MD
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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Burton, MI
• Providers in Burton, 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 9, 2008; 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.