CAFE OF LIFE FENTON, LLC (NPI# 1891913927) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891913927 |
| Entity Type | Organization |
| Organization Name | CAFE OF LIFE FENTON, LLC |
| Practice Address |
114 W Caroline St Fenton MI 48430-3802 |
| Practice Telephone | 8106296023 |
| Practice Fax Number | 8106296024 |
| Mailing Telephone | 8106296023 |
| Mailing Fax Number | 8106296024 |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. ERICA MARIE PEABODY (OWNER) |
| Authorized Official Telephone | 8106296023 |
| Authorized Official Credential | D.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 2301008978 | MI | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 1000662 | 05 |
| Street Address |
114 W CAROLINE ST |
| City | FENTON |
| State | MI |
| Zip Code | 48430-3802 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174532378 | Brian E Stone | Chiropractor | 114 W Caroline St, Stone Chiropractic, Fenton, MI 48430 | 2006-08-05 |
| 1073648168 | Erica Marie Peabody | Chiropractor | 114 W Caroline St, Fenton, MI 48430-3802 | 2007-02-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225647514 | Drs Mesh, P.C. | Dentist | 15555 Silver Parkway, Fenton, MI 48430 | 2020-07-23 |
| 1225515091 | Erica Anderson | Social Worker | 127 River St., Fenton, MI 48430 | 2018-07-25 |
| 1245767888 | Optimum Balance | Clinic/Center | 1537 N. Leroy Street, Suite D, Fenton, MI 48430 | 2017-05-14 |
| 1710411293 | Abdul Hassan | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 11 Chateaux Du Lac, Fenton, MI 48430 | 2017-04-12 |
| 1366994410 | Intentional Wellbeing LLC | Psychologist | 1122 N. Leroy Rd, Suite A, Fenton, MI 48430 | 2016-10-25 |
| 1265801625 | Shawn Marie Gorkiewicz | Nurse Practitioner | 435 North Leroy, Fenton, MI 48430 | 2015-09-16 |
| 1972994226 | Carrie Hamilton | Physical Medicine & Rehabilitation | 102 N Adelaide St Ste B, Fenton, MI 48430 | 2015-02-09 |
| 1104222520 | Wellbridge of Fenton, LLC | Skilled Nursing Facility | 901 Pine Creek Drive, Fenton, MI 48430 | 2014-11-12 |
| 1225442759 | Joseph Matthew Leppek | Optometrist | 1425 N. Leroy St., Fenton, MI 48430 | 2014-06-12 |
| 1437569647 | Therapy Support Center LLC | Clinic/Center | 113 North River Street, Fenton, MI 48430 | 2014-04-28 |
| Find all providers in zip 48430 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033673389 | Revival Chiropractic LLC | Chiropractor | 464 Old Smizer Mill Rd, Fenton, MO 63026-3553 | 2019-01-30 |
| 1184046039 | Painless Chiropractic, Pllc | Chiropractor | 2803 W Silver Lake Rd, Fenton, MI 48430-2655 | 2014-01-13 |
| 1265871776 | Michael Ryan Zwiener | Chiropractor | 672 Gravois Bluffs Blvd, Fenton, MO 63026-7714 | 2013-06-18 |
| 1861751166 | Kyle Matthew Tiefel | Chiropractor | 1525 Bowles Ave Ste C, Fenton, MO 63026-2310 | 2012-05-08 |
| 1881902286 | Jaime L Rosewarne | Chiropractor | 1537 N Leroy St, Suite F, Fenton, MI 48430-2795 | 2010-09-20 |
| 1205157773 | Cambridge Medical for Men LLC | Chiropractor | 900 S Highway Dr Ste 300, Fenton, MO 63026-2042 | 2010-06-18 |
| 1215116751 | Richard Preston Stork | Chiropractor | 1549 N Leroy St, Suite B, Fenton, MI 48430-2790 | 2007-11-01 |
| 1912118191 | James P. Sweeney | Chiropractor | 20 Ashgate Ct, Fenton, MO 63026-3101 | 2007-05-27 |
| 1922121912 | Fenton Chiropractic and Rehab Center, Inc | Chiropractor | 651 Gravois Rd, Fenton, MO 63026-4136 | 2007-04-06 |
| 1538288048 | Chiropractic Accident Center of Fenton, P.C. | Chiropractor | 408 Gravois Rd, Fenton, MO 63026-4133 | 2007-03-28 |
| Find all providers in FENTON | ||||
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| 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.