Seventy Sixth Street Afc LLC

Primary specialty

Respite CareTaxonomy code 385H00000X

License

AM410285883 Issued in MI

Legal business name

SEVENTY SIXTH STREET AFC LLC

Practice address

3554 76TH St SE
Caledonia, MI 49316-9113

Phone

(616) 698-6681

Fax

(616) 698-6681

NPI assigned

Jan 14, 2012

Organization subpart

No

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

Authorized official

Name

Mrs. Debra Ann Krajewski

Title

Owner

Phone

(616) 318-1961

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• James Nelson, DPM

  • Podiatrist
  • Wyoming, MI
  • NPI 1346356219
  NPD (past)

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

{
    "created_epoch": "1326499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326499200000",
    "number": "1962773408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6026 KALAMAZOO AVE SE",
            "address_2": "#296",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495087018",
            "telephone_number": "616-318-1961",
            "fax_number": "616-891-0838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3554 76TH ST SE",
            "city": "CALEDONIA",
            "state": "MI",
            "postal_code": "493169113",
            "telephone_number": "616-698-6681",
            "fax_number": "616-698-6681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEVENTY SIXTH STREET AFC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-14",
        "last_updated": "2012-01-14",
        "status": "A",
        "authorized_official_last_name": "KRAJEWSKI",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-318-1961",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "MI",
            "license": "AM410285883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rory Scott
• Korey Searle, DDS, MS
• Seif Chiropractic PC
• Eric William Seif, D.C.
• Tanya Marie Seif, D.C.
• Yuan Shang, NP
• Eric Shankin
• Cecily L Sherlock Huizing, LMSW
• Shiloh Counseling PLLC
• Brittany Silverthorn, DPT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2012; 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.