Healthcare Provider Details

I. General information

NPI: 1003747528
Provider Name (Legal Business Name): FUN DAY ADULT DAY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2026
Last Update Date: 05/25/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4850 CONNER ST
DETROIT MI
48215-2031
US

IV. Provider business mailing address

18930 ADRIAN ST
SOUTHFIELD MI
48075-1785
US

V. Phone/Fax

Practice location:
  • Phone: 248-361-4818
  • Fax:
Mailing address:
  • Phone: 248-361-4818
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. CURTIS RAY CANNON
Title or Position: OWNER
Credential:
Phone: 248-361-4818