Allegan County 4-H Clubs

Primary specialty

Respite Care CampTaxonomy code 385HR2050X

License

CR030200347 Issued in MI

Legal business name

ALLEGAN COUNTY 4-H CLUBS

Doing business as

4-H Camp Kidwell

Practice address

39000 1St Ave
Bloomingdale, MI 49026-9743

Phone

(269) 521-3559

Fax

(866) 324-2797

NPI assigned

May 11, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Kevin F Kelly

Title

Director

Phone

(269) 521-3559

Specialties & licenses 1

Addresses

Other names 1

• 4-H Camp Kidwell Doing business as

Locations

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494460800000",
    "number": "1891221842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39000 1ST AVE",
            "city": "BLOOMINGDALE",
            "state": "MI",
            "postal_code": "490269743",
            "telephone_number": "269-521-3559",
            "fax_number": "866-324-2797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39000 1ST AVE",
            "city": "BLOOMINGDALE",
            "state": "MI",
            "postal_code": "490269743",
            "telephone_number": "269-521-3559",
            "fax_number": "866-324-2797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLEGAN COUNTY 4-H CLUBS",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-11",
        "last_updated": "2017-05-11",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "269-521-3559",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "385HR2050X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care Camp",
            "state": "MI",
            "license": "CR030200347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "4-H Camp Kidwell",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bethany Care Center L.L.C (Metron of Bloomingdale)
• Bloomingdale Care Operating Co LLC
• Bloomingdale Senior Services LLC
• Gustavo Bonilla Alejandro
• Breeze Medical Equipment, LLC

• Respite Care in Bloomingdale, MI
• Providers in Bloomingdale, MI by specialty
• Respite Care in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 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.