Lake Fenton Haus Inc

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

LAKE FENTON HAUS INC

Practice address

12287 Margaret Dr
Fenton, MI 48430

Phone

(810) 629-7969

NPI assigned

Nov 9, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Kathleen Marie Huber, EXECUTIVE DIRECTORNPI 1790913499

Title

Owner Executive Director

Phone

(810) 629-7969

Specialties & licenses 1

Addresses

Practitioners 1

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

• Kathleen M Huber

  • Community Health Worker
  • Fenton, MI
  • NPI 1790913499
  NPD (past) Authorized official

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1811067465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12287 MARGARET DR",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "48430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12287 MARGARET DR",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "48430",
            "telephone_number": "810-629-7969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE FENTON HAUS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HUBER",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "810-629-7969",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "EXECUTIVE DIRECTOR"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tamara Kreifeldt
• Kroger Co of Michigan
• Leslie Ann Krol, MA, LPC
• Tamara Lynn Kulchar
• Kurtis Lahring, LMSW-C
• Ashley Louise Lamb, FNP-C
• Elyse Lamphier
• Kimberly Kay Lange, FNP-BC
• Larry L Pack MD PC
• Laurie Denise Lawlor-Clark, CPS, MSW

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Fenton, MI
• Providers in Fenton, MI by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.