Eastport Village Care Home LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

EASTPORT VILLAGE CARE HOME LLC

Practice address

5988 N M 88
Central Lake, MI 49622-9464

Phone

(231) 631-1836

NPI assigned

Mar 19, 2021

Organization subpart

No

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

Authorized official

Name

Melanie White

Title

Owner

Phone

(231) 631-1836

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1616112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616371200000",
    "number": "1871179051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 264",
            "city": "EASTPORT",
            "state": "MI",
            "postal_code": "496270264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5988 N M 88",
            "city": "CENTRAL LAKE",
            "state": "MI",
            "postal_code": "496229464",
            "telephone_number": "231-631-1836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTPORT VILLAGE CARE HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-19",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "MELANIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "231-631-1836"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "office@epvch.com",
            "affiliation": "N",
            "endpointDescription": "office@epvch.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5988 N M 88",
            "city": "Central Lake",
            "state": "MI",
            "country_code": "US",
            "postal_code": "496229464",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Central Lake Pharmacy Inc (Central Lake Pharmacy)
• Duane L Chappuies
• David Dibble DDS PC
• David Lee Dibble, DDS
• East Jordan Family Health Center (Central Lake Family Health Center)
• Karen Adkins Ferguson, RPH
• Kim Edward Forster, R.PH
• Andrea Kline, CADC. CPRC
• Briana Marie Padgett, PSY S
• Shantel Mary Potter, NPI

• Assisted Living Facility in Central Lake, MI
• Providers in Central Lake, MI by specialty
• Assisted Living Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2021; 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.