Healthcare Provider Details

I. General information

NPI: 1720126204
Provider Name (Legal Business Name): JAM SENIOR SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2980 DORR RD SUITE 102
BRIGHTON MI
48116-9459
US

IV. Provider business mailing address

2980 DORR RD SUITE 102
BRIGHTON MI
48116-9459
US

V. Phone/Fax

Practice location:
  • Phone: 810-229-0200
  • Fax: 810-220-7916
Mailing address:
  • Phone: 810-229-0200
  • Fax: 810-220-7916

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State

VIII. Authorized Official

Name: MRS. MARYANN MADSEN
Title or Position: EXECUTIVE DIRECTOR OF OPERATIONS
Credential: RN
Phone: 810-229-0200