NPIMap

Organization Active NPI

Mizpah Group Home Inc

  • Early Intervention Provider Agency
  • Southfield, MI
National Provider Identifier
1811429798
Registry record updated Mar 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
Legal business name
MIZPAH GROUP HOME INC
Practice address
24375 Lafayette Cir
Southfield, MI 48075-2560
Phone
(248) 796-2639
Fax
(248) 796-2639
NPI assigned
Mar 30, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2017

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

Authorized official

Name
Mr. Alonzo Kevin Morgan Sr., M.S.NPI 1609105634
Title
Director
Phone
(248) 796-2639

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
Public Health or Welfare Agency 251K00000X
Voluntary or Charitable Agency 251V00000X
Early Intervention Provider Agency 252Y00000X Primary

Addresses

Primary practice location

24375 Lafayette Cir
Southfield, MI 48075-2560

Mailing address

24375 Lafayette Cir
Southfield, MI 48075-2560
Phone (248) 796-2639

National Provider Directory

National Provider Directory
Tax ID family
Mizpah Group Home Inc2 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.

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": "1490832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490832000000",
    "number": "1811429798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24375 LAFAYETTE CIR",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480752560",
            "telephone_number": "248-796-2639",
            "fax_number": "248-796-2639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24375 LAFAYETTE CIR",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480752560",
            "telephone_number": "248-796-2639",
            "fax_number": "248-796-2639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIZPAH GROUP HOME INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-30",
        "last_updated": "2017-03-30",
        "status": "A",
        "authorized_official_last_name": "MORGAN",
        "authorized_official_first_name": "ALONZO",
        "authorized_official_middle_name": "KEVIN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "248-796-2639",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "M.S."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2017; 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.