Provider Demographics
NPI:1003842444
Name:MAYFIELD ADULT FOSTER CARE HOME, INC.
Entity Type:Organization
Organization Name:MAYFIELD ADULT FOSTER CARE HOME, INC.
Other - Org Name:MAYFIELD AFC HOME, INC.
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:MCBEAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-742-7931
Mailing Address - Street 1:1113 E HEMPHILL RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-2835
Mailing Address - Country:US
Mailing Address - Phone:810-742-7931
Mailing Address - Fax:
Practice Address - Street 1:1113 E HEMPHILL RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-2835
Practice Address - Country:US
Practice Address - Phone:810-742-7931
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities