Provider Demographics
NPI:1932937950
Name:SUBIRA HOMES AFC
Entity type:Organization
Organization Name:SUBIRA HOMES AFC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/OENER
Authorized Official - Prefix:
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:
Authorized Official - Last Name:MBOCHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-908-3349
Mailing Address - Street 1:5164 DOHERTY DR
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48323-3409
Mailing Address - Country:US
Mailing Address - Phone:817-908-3349
Mailing Address - Fax:
Practice Address - Street 1:5164 DOHERTY DR
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48323-3409
Practice Address - Country:US
Practice Address - Phone:248-296-0444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-22
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No251J00000XAgenciesNursing Care
No253J00000XAgenciesFoster Care Agency