| NPI Number | 1649899485 |
| Provider Name | Judah Go Global Foundation, Llc |
| Authorized Official | Name: Tamara Sanderfield Title: Chief Executive Officer Phone: 734-510-9972 |
| Status | |
| Entity Type | Organization |
| Enumeration Date | 04/12/2020 |
| Last Update Date | 04/11/2022 |
| Organization Subpart | N |
| Business Practice address |
33 LABELLE ST APT 610, Highland Park, 48203-3687 Michigan View on Google Map |
| Business Practice phone | 615-510-4160 |
| Business Practice fax | |
| Mailing address |
4206 PACKARD ST APT 2, Ann Arbor, 48108-1525 Michigan View on Google Map |
| Other phone | 888-958-5640 |
| Other fax | |
| Email Address | shannonfig@domain.com Reval Email Address |
| Field Name | Field Value |
|---|---|
| NPI | 1649899485 |
| 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. | |
| Entity Type | Organization |
Code describing the type of health care provider that is being assigned an NPI. Codes are:
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| Is Organization Subpart | N |
| The "Is the organization a subpart?" question must be answered. If the organization is a subpart = , the Parent Organization Legal Business Name (LBN) and Parent Organization Taxpayer Identification Number (TIN) fields must be completed. The Parent Organization LBN and TIN fields can only be completed if the answer to the subpart question is Yes. Many organization health care providers who apply for NPIs are not legal entities themselves but are parts of other organization health care providers that are legal entities (the "parents"). Here are three examples of organization health care providers that may be considered subparts and may apply for NPIs if so directed by their "parents": (1) The psychiatric unit in a hospital is not a legal entity but is part of the hospital (the "parent"), which is a legal entity. The legal entity must obtain an NPI. The psychiatric unit is an example of a subpart that could have its own NPI if the hospital determines that it should. (2) A group practice that is not a sole proprietorship has a main location and could have other offices in different locations, but each office is not a separate legal entity; instead, each office is part of the corporation (the "parent") which is a legal entity. The offices are examples of subparts that could have their own NPIs if the main location determines that they should. (3) A pharmacy fills prescriptions for patients whose physicians have prescribed medications for them and may also rent or sell durable medical equipment to patients whose physicians have ordered such equipment for them. Neither the pharmacy line of business nor the DME line of business represent legal entities; instead, both lines of business are part of an organization (the "parent") that is a legal entity. Each line of business represents a different Healthcare Provider Taxonomy or area of specialization that often submits its own electronic claims to health plans. The "parent"-we don't know who the parent is in this example-must ensure that each subpart that submits its own claims to health plans has its own NPI. | |
| Provider Organization Name (Legal Business Name) | Judah Go Global Foundation, Llc |
| Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. | |
| Provider First Line Business Mailing Address | 4206 PACKARD ST APT 2 |
| 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 Business Mailing Address City Name | Ann Arbor |
| The City name in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address City name''. | |
| Provider Business Mailing Address State Name | Michigan |
| The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address State name''. | |
| Provider Business Mailing Address Postal Code | 48108-1525 |
| 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 | US |
| The country code in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address country code''. | |
| Provider Business Mailing Address Telephone Number | 888-958-5640 |
| 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 First Line Business Practice Location Address | 33 LABELLE ST APT 610 |
| 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 | Highland Park |
| The city name in the location address of the provider being identified. | |
| Provider Business Practice Location Address State Name | Michigan |
| The State or Province name in the location address of the provider being identified. | |
| Provider Business Practice Location Address Postal Code | 48203-3687 |
| The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. | |
| Provider Business Practice Location Address Country Code | US |
| The country code in the location address of the provider being identified. | |
| Provider Business Practice Location Address Telephone Number | 615-510-4160 |
| The telephone number associated with the location address of the provider being identified. | |
| Provider Enumeration Date | 04/12/2020 |
| The date the provider was assigned a unique identifier (assigned an NPI). | |
| Last Update Date | 04/11/2022 |
| The date that a record was last updated or changed. | |
| Authorized Official Last Name | Sanderfield |
| 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 | Tamara |
| The first name of the authorized official | |
| Authorized Official Title or Position | Chief Executive Officer |
| The title or position of the authorized official | |
| Authorized Official Telephone Number | 734-510-9972 |
| The 10-position telephone number of the authorized official. | |
| Healthcare Provider Taxonomy Code #1 | 3418M1110X |
| The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization. | |
| Healthcare Provider Taxonomy 1 | Vehicle and staff for patient emergency or non-emergency ground transport. Includes traditional ambulances as well as ambulance buses. |
| Healthcare Provider Taxonomy #1 | |
| Healthcare Provider Primary Taxonomy Switch 1 | N |
Primary Taxonomy:
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| Healthcare Provider Taxonomy Code #2 | 251B00000X |
| The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization. | |
| Healthcare Provider Taxonomy 2 | An organization that is responsible for providing case management services. The agency provides services which assist an individual in gaining access to needed medical, social, educational, and/or other services. Case management services may be used to locate, coordinate, and monitor necessary appropriate services. It may be used to encourage the use of cost-effective medical care by referrals to appropriate providers and to discourage over utilization of costly services. Case management may also serve to provide necessary coordination of non-medical services such as vocational rehabilitation, education, employment, when the services provided enable the individual to function at the highest level. |
| Healthcare Provider Taxonomy #2 | |
| Healthcare Provider Primary Taxonomy Switch 2 | N |
Primary Taxonomy:
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| Healthcare Provider Taxonomy Code #3 | 251G00000X |
| The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization. | |
| Healthcare Provider Taxonomy 3 | Definition to come... |
| Healthcare Provider Taxonomy #3 | |
| Healthcare Provider Primary Taxonomy Switch 3 | N |
Primary Taxonomy:
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| Healthcare Provider Taxonomy Code #4 | 251K00000X |
| The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization. | |
| Healthcare Provider Taxonomy 4 | Definition to come... |
| Healthcare Provider Taxonomy #4 | |
| Healthcare Provider Primary Taxonomy Switch 4 | N |
Primary Taxonomy:
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| Healthcare Provider Taxonomy Code #5 | 251S00000X |
| The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization. | |
| Healthcare Provider Taxonomy 5 | A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Healthcare Provider Taxonomy #5 | |
| Healthcare Provider Primary Taxonomy Switch 5 | N |
Primary Taxonomy:
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| Healthcare Provider Taxonomy Code #6 | 253Z00000X |
| The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization. | |
| Healthcare Provider Taxonomy 6 | An In Home Supportive Care Agency provides services in the patient's home with the goal of enabling the patient to remain at home. The services provided may include personal care services such as hands-on assistance with activities of daily living (ADLs), e.g., eating, bathing, dressing, and bladder and bowel requirements; homemaker services and instrumental activities of daily living (IADLs), e.g., taking medications, shopping for groceries, laundry, housekeeping, and companionship; and/or supervision or cuing so that a person can perform tasks themselves. |
| Healthcare Provider Taxonomy #6 | |
| Healthcare Provider Primary Taxonomy Switch 6 | N |
Primary Taxonomy:
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| Healthcare Provider Taxonomy Code #7 | 261Q00000X |
| The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization. | |
| Healthcare Provider Taxonomy 7 | A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| Healthcare Provider Taxonomy #7 | |
| Healthcare Provider Primary Taxonomy Switch 7 | N |
Primary Taxonomy:
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| Healthcare Provider Taxonomy Code #8 | 261Q00000X |
| The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization. | |
| Healthcare Provider Taxonomy 8 | A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| Healthcare Provider Taxonomy #8 | |
| Healthcare Provider Primary Taxonomy Switch 8 | N |
Primary Taxonomy:
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| Healthcare Provider Taxonomy Code #9 | 261QE0002X |
| The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization. | |
| Healthcare Provider Taxonomy 9 | Definition to come... |
| Healthcare Provider Taxonomy #9 | |
| Healthcare Provider Primary Taxonomy Switch 9 | N |
Primary Taxonomy:
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| Healthcare Provider Taxonomy Code #10 | 261QH0100X |
| The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization. | |
| Healthcare Provider Taxonomy 10 | Definition to come... |
| Healthcare Provider Taxonomy #10 | |
| Healthcare Provider Primary Taxonomy Switch 10 | N |
Primary Taxonomy:
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| Healthcare Provider Taxonomy Code #11 | 261QM0850X |
| The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization. | |
| Healthcare Provider Taxonomy 11 | An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Healthcare Provider Taxonomy #11 | |
| Healthcare Provider Primary Taxonomy Switch 11 | N |
Primary Taxonomy:
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| Healthcare Provider Taxonomy Code #12 | 261QP2300X |
| The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization. | |
| Healthcare Provider Taxonomy 12 | Definition to come... |
| Healthcare Provider Taxonomy #12 | |
| Healthcare Provider Primary Taxonomy Switch 12 | N |
Primary Taxonomy:
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| Healthcare Provider Taxonomy Code #13 | 282NR1301X |
| The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization. | |
| Healthcare Provider Taxonomy 13 | Definition to come... |
| Healthcare Provider Taxonomy #13 | |
| Healthcare Provider Primary Taxonomy Switch 13 | N |
Primary Taxonomy:
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| Healthcare Provider Taxonomy Code #14 | 261QF0400X |
| The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization. | |
| Healthcare Provider Taxonomy 14 | Definition to come... |
| Healthcare Provider Taxonomy #14 | |
| Healthcare Provider Primary Taxonomy Switch 14 | Y |
Primary Taxonomy:
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