NPI 1750832564 · live from the CMS NPI Registry
First Door, LLC
Custodial Care Facility in Southfield, MI. National Provider Identifier 1750832564, active.
NPI record
| NPI | 1750832564 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Custodial Care Facility 311Z00000X |
| Practice location | 25584 W 10 Mile Rd, Southfield, MI 48033 |
| Practice phone | 248-877-8401 |
| Enumerated | October 17, 2016 |
| Last updated | November 13, 2018 |
| Authorized official | Modeira Johnson, Owner/Ceo/President |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Residential Treatment Facility, Physical Disabilities | 320700000X | AS630369663 (MI) |
| Clinic/Center, Rehabilitation | 261QR0400X | — |
| Community Based Residential Treatment Facility, Mental Illness | 320800000X | AS630369663 (MI) |
| Respite Care | 385H00000X | AS630369663 (MI) |
| Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) | 261QR0401X | — |
| Custodial Care Facility, Adult Care Home | 311ZA0620X | AS630369663 (MI) |
| Skilled Nursing Facility | 314000000X | — |
| Custodial Care Facility primary | 311Z00000X | AS630369663 (MI) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.