Healthcare Provider Details

I. General information

NPI: 1740017250
Provider Name (Legal Business Name): SEKENAH R DAYE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2024
Last Update Date: 09/21/2025
Certification Date: 09/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

142 S BROADWAY ST
CASSOPOLIS MI
49031-1243
US

IV. Provider business mailing address

28687 POKAGON HWY
DOWAGIAC MI
49047-9710
US

V. Phone/Fax

Practice location:
  • Phone: 269-228-8034
  • Fax:
Mailing address:
  • Phone: 269-228-8034
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. SEKENAH TENNISON
Title or Position: CEO
Credential: MA
Phone: 269-591-2894