Healthcare Provider Details

I. General information

NPI: 1275440695
Provider Name (Legal Business Name): ARDEN PARK COMMUNITY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2790 OAKMAN BLVD
DETROIT MI
48238-2558
US

IV. Provider business mailing address

2790 OAKMAN BLVD
DETROIT MI
48238-2558
US

V. Phone/Fax

Practice location:
  • Phone: 215-614-9801
  • Fax:
Mailing address:
  • Phone: 215-614-9801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVONTI' DEANGELO HAYNES
Title or Position: OWNER
Credential: MSW, PHD
Phone: 215-614-9801