Healthcare Provider Details

I. General information

NPI: 1194445189
Provider Name (Legal Business Name): LAY'S MANAGEMENT COMPANY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2022
Last Update Date: 12/07/2023
Certification Date: 12/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3461 W OUTER DR
DETROIT MI
48221-1668
US

IV. Provider business mailing address

18554 CAPITOL DR
SOUTHFIELD MI
48075-2609
US

V. Phone/Fax

Practice location:
  • Phone: 313-340-2425
  • Fax: 248-327-7981
Mailing address:
  • Phone: 313-790-3322
  • Fax: 248-327-7981

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: VANESSA LAY
Title or Position: PROVIDER/DIRECTOR
Credential:
Phone: 313-790-3322