Healthcare Provider Details

I. General information

NPI: 1982255196
Provider Name (Legal Business Name): QUALITY FAMILY GROUP PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2019
Last Update Date: 09/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18254 LIVERNOIS AVE
DETROIT MI
48221-4214
US

IV. Provider business mailing address

18462 PIERRE DR
CLINTON TOWNSHIP MI
48038-1261
US

V. Phone/Fax

Practice location:
  • Phone: 313-732-1015
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: HERBERT ISAAC II
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 313-333-7944