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LUTHERAN HOME-LIVONIA
Complete NPI Record 1932103678
Skilled Nursing Facility in Livonia, MI

NPI Status: Active since June 10, 2005

Contact Information

28910 PLYMOUTH RD
LIVONIA, MI
ZIP 48150
Phone: (734) 425-4814
Fax: (734) 425-6024

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Employer Identification Number EIN
  4. Provider Organization Name Legal Business Name
  5. Provider Other Organization Name
  6. Provider Other Organization Name Type Code
  7. Provider First Line Business Mailing Address
  8. Provider Second Line Business Mailing Address
  9. Provider Business Mailing Address City Name
  10. Provider Business Mailing Address State Name
  11. Provider Business Mailing Address Postal Code
  12. Provider Business Mailing Address Country Code If outside U S
  13. Provider Business Mailing Address Telephone Number
  14. Provider Business Mailing Address Fax Number
  15. Provider First Line Business Practice Location Address
  16. Provider Business Practice Location Address City Name
  17. Provider Business Practice Location Address State Name
  18. Provider Business Practice Location Address Postal Code
  19. Provider Business Practice Location Address Country Code If outside U S
  20. Provider Business Practice Location Address Telephone Number
  21. Provider Business Practice Location Address Fax Number
  22. Provider Enumeration Date
  23. Last Update Date
  24. Authorized Official Last Name
  25. Authorized Official First Name
  26. Authorized Official Middle Name
  27. Authorized Official Title or Position
  28. Authorized Official Telephone Number
  29. Healthcare Provider Taxonomy Code 1
  30. Provider License Number 1
  31. Provider License Number State Code 1
  32. Healthcare Provider Primary Taxonomy Switch 1
  33. Other Provider Identifier 1
  34. Other Provider Identifier Type Code 1
  35. Other Provider Identifier State 1
  36. Other Provider Identifier 2
  37. Other Provider Identifier Type Code 2
  38. Other Provider Identifier State 2
  39. Other Provider Identifier Issuer 2
  40. Is Organization Subpart
  41. Parent Organization LBN
  42. Parent Organization TIN
  43. Authorized Official Name Prefix Text

Complete NPI Dataset

This page represents the complete record for NPI 1932103678. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1932103678
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 2
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EIN: UNAVAIL
The last name of the provider. If the provider is an individual, this is the legal name.
The name of the organization provider. If the provider is an organization, this is the legal business name.
Provider Other Organization Name: LUTHERAN HOME-LIVONIA
Other name by which the organization provider is or has been known.
Provider Other Organization Name Type Code: 3
Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
Provider First Line Business Mailing Address: 9710 JUNCTION RD
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Second Line Business Mailing Address: P.O. BOX 329
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address City Name: FRANKENMUTH
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: MI
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address Postal Code: 487340329
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S : US
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Telephone Number: 9896523470
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Business Mailing Address Fax Number: 9896523480
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Provider First Line Business Practice Location Address: 28910 PLYMOUTH RD
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: LIVONIA
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address State Name: MI
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 481502337
The State code in the location of the provider being identified.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 7344254814
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 7344256024
The fax number associated with the location address of the provider being identified.
Provider Enumeration Date: 6/10/2005
The fax number associated with the location address of the provider being identified.
Last Update Date: 9/11/2007
The date that a record was last updated or changed.
Authorized Official Last Name: CORBY
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First Name: MICHAEL
The first name of the authorized official.
Authorized Official Middle Name: G
The middle name of the authorized official.
Authorized Official Title or Position: CONTROLLER
The title or position of the authorized official.
Authorized Official Telephone Number: 9896523470
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Healthcare Provider Taxonomy Code 1: 314000000X
The last name of the provider. If the provider is an individual, this is the legal name.
Provider License Number 1: 824200
The first name of the provider, if the provider is an individual.
Provider License Number State Code 1: MI
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 1: Y
Other Provider Identifier 1: 4076769
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 1: 05
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Other Provider Identifier State 1: MI
Other Provider Identifier 2: S 9505
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 2: 01
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Other Provider Identifier State 2: MI
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Other Provider Identifier Issuer 2: BCBS INS. PROVIDER #
The city name in the location address of the provider being identified.
Is Organization Subpart: Y
The State code in the location of the provider being identified.
Parent Organization LBN: LUTHERAN HOMES OF MICHIGAN, INC
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Parent Organization TIN: UNAVAIL
Authorized Official Name Prefix Text: MR.