FIRST DOOR, LLC (NPI# 1750832564) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750832564 |
| Entity Type | Organization |
| Organization Name | FIRST DOOR, LLC |
| Practice Address |
25584 W 10 Mile Rd Southfield MI 48033-4826 |
| Practice Telephone | 2488778401 |
| Practice Fax Number | 3134543102 |
| Mailing Telephone | 2488778401 |
| Mailing Fax Number | 3134543102 |
| Enumeration Date | 2016-10-17 |
| Last Update Date | 2018-11-13 |
| Authorized Official Name | MR. MODEIRA JOHNSON SR. (OWNER/CEO/PRESIDENT) |
| Authorized Official Telephone | 2488778401 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 320700000X | Residential Treatment Facility, Physical Disabilities | AS630369663 | MI | Residential Treatment Facilities |
| N | 261QR0400X |
Clinic/Center Specialization: Rehabilitation |
Ambulatory Health Care Facilities | ||
| N | 320800000X | Community Based Residential Treatment Facility, Mental Illness | AS630369663 | MI | Residential Treatment Facilities |
| N | 385H00000X | Respite Care | AS630369663 | MI | Respite Care Facility |
| N | 261QR0401X |
Clinic/Center Specialization: Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
Ambulatory Health Care Facilities | ||
| N | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
AS63036966 | MI | Nursing & Custodial Care Facilities |
| N | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities | ||
| Y | 311Z00000X | Custodial Care Facility | AS63036966 | MI | Nursing & Custodial Care Facilities |
| Street Address |
25584 W 10 MILE RD |
| City | SOUTHFIELD |
| State | MI |
| Zip Code | 48033-4826 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013531243 | Kenicka Harper | Case Manager/Care Coordinator | 2270 W Nine Mile Rd, Detroit, MI 48033 | 2020-06-03 |
| 1154955292 | Judy C Staples | Registered Nurse | 23800 West 10 Mile Road, Ste. 110, Southfield, MI 48033 | 2020-02-27 |
| 1578193827 | Axel Lee Gruenberg | Peer Specialist | 221790 West 9 Mile, Southfield, MI 48033 | 2020-01-24 |
| 1851958706 | William Beaumont Hospital | Clinic/Center | 26901 Beaumont Blvd., D - 5, Community Health, Southfield, MI 48033 | 2019-05-28 |
| 1396302857 | William Beaumont Hospital | Clinic/Center | Beaumont Service Center, 26901 Beaumont Blvd, Community Health, D - 5, Southfield, MI 48033 | 2019-05-21 |
| 1700442597 | Botsford General Hospital | Clinic/Center | 26901 Beaumont Blvd, Beaumont Service Center, Community Health, D - 5, Southfield, MI 48033 | 2019-05-16 |
| 1558862433 | Oakwood Accountable Care Organization, LLC | Preferred Provider Organization | 26901 Beaumont Blvd., Southfield, MI 48033 | 2018-02-26 |
| 1891228904 | Brandi Becker-wright | Social Worker | 25200 Telegraph Rd Ste 100, Southfield, MI 48033 | 2017-04-05 |
| 1003362252 | Mark Kline | Registered Nurse | 22170 W Nine Mile Rd, Southfield, MI 48033 | 2016-08-28 |
| 1033534797 | Jessica Savageau | Social Worker | 22170 W 9 Mile, Southfield, MI 48033 | 2014-03-04 |
| Find all providers in zip 48033 | ||||
| Taxonomy Code | 311Z00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| A facility providing care that serves to assist an individual in the activities of daily living, such as assistance in walking, getting in and out of bed, bathing, dressing, feeding, and using the toilet, preparation of special diets, and supervision of medication that usually can be self-administered. Custodial care essentially is personal care that does not require the continuing attention of trained medical or paramedical personnel. |
| Notes: Source: Paraphrased from Section 3159 A3 of the Medicare Intermediary Manual. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518564715 | Nicole Marie Hutchinson | Custodial Care Facility | 519 S Vander Meulen Rd, Lake City, MI 49651-8717 | 2020-10-01 |
| 1831796028 | Sheila Ann Breiler | Custodial Care Facility | 631 S Vander Meulen Rd, Lake City, MI 49651-9367 | 2020-10-01 |
| 1033726427 | M & T Adult Foster Care, Inc | Custodial Care Facility | 5478 210th Ave, Reed City, MI 49677-8626 | 2020-09-29 |
| 1457974388 | Leeanne Marie Love Woolley | Custodial Care Facility | 621 S M 30, Gladwin, MI 48624-8443 | 2020-05-27 |
| 1326675950 | Timothy Alan Rantz | Custodial Care Facility | 1564 N M 63, Benton Harbor, MI 49022-2759 | 2020-03-24 |
| 1437782075 | Sharon Lynn Dewey | Custodial Care Facility | 1425 Ziggy Rd., Farwell, MI 48622 | 2020-02-21 |
| 1164055380 | Palmer's Place Inc | Custodial Care Facility | 1009 S. St. Johns Rd, Ithaca, MI 48847 | 2020-02-17 |
| 1508400771 | Margaret M Dandron | Custodial Care Facility | 5740 Twin Lake Ave, Lake, MI 48632 | 2019-10-31 |
| 1831747500 | Rhonda L Owens | Custodial Care Facility | 3819 S Wise Rd, Mount Pleasant, MI 48858-8100 | 2019-08-27 |
| 1346711546 | Nationwide Community Housing Inc | Custodial Care Facility | 14391 Coyle St, Detroit, MI 48227-2585 | 2018-12-16 |
| Find all providers with the same taxonomy | ||||
| City | SOUTHFIELD |
| Zip Code | 48033 |
Please comment or provide details below to improve the information on FIRST DOOR, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.