Stoneridge Adult Foster Care

Primary specialty

Assisted Living Facility (Behavioral Disturbances)Taxonomy code 3104A0630X

License

AL080338716 Issued in MI

Legal business name

STONERIDGE ADULT FOSTER CARE

Practice address

4825 Fruin Rd
Bellevue, MI 49021-8209

Phone

(269) 758-3388

Fax

(269) 758-3488

NPI assigned

Feb 10, 2015

Last updated

Feb 10, 2015By 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. Michelle Lynn Moore, RN

Title

Manager

Phone

(269) 758-3388

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1423526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423526400000",
    "number": "1942691191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4825 FRUIN RD",
            "city": "BELLEVUE",
            "state": "MI",
            "postal_code": "490218209",
            "telephone_number": "269-758-3388",
            "fax_number": "269-758-3488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4825 FRUIN RD",
            "city": "BELLEVUE",
            "state": "MI",
            "postal_code": "490218209",
            "telephone_number": "269-758-3388",
            "fax_number": "269-758-3488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONERIDGE ADULT FOSTER CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-10",
        "last_updated": "2015-02-10",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "269-758-3388",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "3104A0630X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
            "state": "MI",
            "license": "AL080338716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andreana Nicole Odell
• Rebecca's in Home Care (Rebecca's In Home Care LLC)
• Magan Rivera, LPTA
• Kim Juanita Stewart, RN
• Stone Ridge Afc
• Tami Fradette Counseling LLC
• Benjamin Russell Wilson, LLPC

• Assisted Living Facility (Behavioral Disturbances) in Bellevue, MI
• Providers in Bellevue, MI by specialty
• Assisted Living Facility (Behavioral Disturbances) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2015; 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.