AH LAKESIDE II LDHA LLC (NPI# 1912529876) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912529876 |
| Entity Type | Organization |
| Organization Name | AH LAKESIDE II LDHA LLC |
| Practice Address |
15821 19 Mile Rd Clinton Township MI 48038-6320 |
| Practice Telephone | 5862630081 |
| Practice Fax Number | 5864121672 |
| Mailing Telephone | 5862630081 |
| Mailing Fax Number | 5864121672 |
| Enumeration Date | 2020-05-14 |
| Last Update Date | 2020-05-14 |
| Authorized Official Name | AUBREY BROHL (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 5862630081 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 376J00000X | Homemaker | Nursing Service Related Providers | ||
| Y | 332U00000X | Home Delivered Meals | Suppliers |
| Street Address |
15821 19 MILE RD |
| City | CLINTON TOWNSHIP |
| State | MI |
| Zip Code | 48038-6320 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447864129 | Raphael Antonio Tramble | Counselor | River Oaks Suites Plaza 42815 Garfield Road, Suite 201, Clinton Township, MI 48038 | 2020-09-01 |
| 1275160384 | Varun C Sankuratri | Obstetrics & Gynecology | 16515 Nineteen Mile Rd, Gme Office: Attention Obgyn PC Kelly Bennet, Clinton Township, MI 48038 | 2020-03-26 |
| 1114563178 | Hopeful Reflections Counseling Center, Pllc | Counselor | 44444 Hayes, Clinton Township, MI 48038 | 2019-11-25 |
| 1588224570 | Karrie Marie Armstrong | Social Worker | 42815 Garfield Rd Macomb Therapy Group, Suite 201, Clinton Twp, MI 48038 | 2019-06-20 |
| 1386201424 | Rx Mart Pharmacy LLC | Pharmacy | 43171 Dalcoma Dr Ste #2, Clinton Twp, MI 48038 | 2019-05-23 |
| 1306314489 | Rx Mart Pharmacy LLC | Pharmacy | 43171 Dalcoma Dr., Suite 2, Clinton Twp, MI 48038 | 2018-11-07 |
| 1730677592 | Najoi Sleiman | Physical Medicine & Rehabilitation | 15855 19-mile Road, Rehab Services, 4th Floor, South Tower, Clinton Twp., MI 48038 | 2018-04-27 |
| 1295230365 | David Michael Ragbeer | Emergency Medicine | Henry Ford Macomb Hospitals, 15855 Nineteen Mile Road, Clinton Township, MI 48038 | 2018-03-29 |
| 1932601317 | Synergy Pharmacy LLC | Pharmacy | 42621 Garfield Rd Ste 101a, Clinton Township, MI 48038 | 2018-03-01 |
| 1689175002 | Melissa Velez Miracle | Speech-Language Pathologist | 38809 Windmill Pointe W, Clinton Twp, MI 48038 | 2018-02-21 |
| Find all providers in zip 48038 | ||||
| Taxonomy Code | 332U00000X |
| Grouping | Suppliers |
| Classification | Home Delivered Meals |
| Home-delivered meals are those services or activities designed to prepare and deliver one or more meals a day to an individual's residence in order to prevent institutionalization, malnutrition, and feelings of isolation. Component services or activities may include the cost of personnel, equipment, and food; assessment of nutritional and dietary needs; nutritional education and counseling; socialization services; and information and referral. |
| Notes: Source: Code of Federal Regulations #45, Part 96, Appendix A, Uniform Definition of Services. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225655517 | Community Outreach Services Corporation | Home Delivered Meals | 9525 E Highland Rd, Howell, MI 48843-9098 | 2020-07-02 |
| 1902209810 | Campau Medical Supplies LLC | Home Delivered Meals | 8638 Joseph Campau St, Hamtramck, MI 48212-3717 | 2014-10-06 |
| 1497182364 | Ja Food Service | Home Delivered Meals | 377 Riford St, Benton Harbor, MI 49022-3417 | 2013-10-08 |
| 1972939809 | Northwest Michigan Community Action Agency | Home Delivered Meals | 3963 3 Mile Rd N, Traverse City, MI 49686-9164 | 2013-09-24 |
| 1487080594 | Cass County Council On Aging | Home Delivered Meals | 60525 Decatur Rd, Cassopolis, MI 49031-8412 | 2013-09-20 |
| 1184846669 | Alleready Foods, L.L.C. | Home Delivered Meals | 10171 Colonial Industrial Dr., South Lyon, MI 48178-9149 | 2007-05-03 |
| 1972724771 | Nutritional Services for Older Americans, Inc. | Home Delivered Meals | 1540 W Sherman Blvd, Muskegon, MI 49441-3543 | 2007-05-01 |
| 1275778458 | Arise Resources Inc | Home Delivered Meals | 11000 W Mcnichols Rd, Detroit, MI 48221-2357 | 2008-12-02 |
| 1144426610 | Washtenaw County | Home Delivered Meals | 555 Towner St, Ypsilanti, MI 48198-5752 | 2007-06-22 |
| City | CLINTON TOWNSHIP |
| Zip Code | 48038 |
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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.