MARK F. PETERSON, I – NPI #1841474012
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.

MARK PETERSON, I is a community based residential treatment facility located in GRAND RAPIDS, MI. NPPES has assigned the NPI number 1841474012 to MARK PETERSON, I on December 24, 2007. It is a Type-1 NPI, indicating this NPI number is associated with an individual. The primary taxonomy selected by this provider is 320900000X from the Health Care Provider Taxonomy code set, which is classified as Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities.

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for MARK PETERSON, I below.

NPI Profile for
MARK F. PETERSON, I

NPI Number
1841474012
Enumeration Date

(more than 18 years ago)
Entity Type
Type-1  Individual (Male)
Legal Name
MARK F. PETERSON, I
Primary location
3351 36TH ST
GRAND RAPIDS, MI 49331
Phone: (616) 831-5659 Fax:
Mailing address
2285 CHRISTINE CT SE
GRAND RAPIDS, MI 49546
Phone: (616) 831-5659 Fax:
Sole Proprietor
Yes
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
320900000X
- Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Primary)
MI 6802071051

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.