BWL Care, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

BWL CARE, LLC

Practice address

16861 Wyoming St
Detroit, MI 48221-2850

Phone

(313) 922-7788

NPI assigned

Jul 17, 2018

Last updated

Jul 17, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Mia Love, NURSE PRACTITIONER

Title

Executive Director

Phone

(313) 922-7788

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Balanced Wholistic Living Other name

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

{
    "created_epoch": "1531785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531785600000",
    "number": "1891271458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19265 CANTERBURY RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482211859",
            "telephone_number": "313-922-7788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16861 WYOMING ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482212850",
            "telephone_number": "313-922-7788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BWL CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-17",
        "last_updated": "2018-07-17",
        "status": "A",
        "authorized_official_last_name": "LOVE",
        "authorized_official_first_name": "MIA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "313-922-7788",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NURSE PRACTITIONER"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000594287",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Balanced Wholistic Living",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Raymond Buttrey
• Jumel Butts
• Paul Edward Butts, M.D.
• Zachary Joseph Buxo, MD
• Jerri Ann Buxton, DDS
• Idellmar Byais, BSW
• Allison Byars, MSW
• Tiauna Byas
• Erin Bybee, MD
• Amanda Byers, AGACNP

• Community/Behavioral Health Agency in Detroit, MI
• Providers in Detroit, MI by specialty
• Community/Behavioral Health Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2018; 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.