Healthcare Provider Details

I. General information

NPI: 1245167675
Provider Name (Legal Business Name): LASHAWN PATRICE MANN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15400 E 7 MILE RD
DETROIT MI
48205-2544
US

IV. Provider business mailing address

26474 ISLEWORTH PT
SOUTHFIELD MI
48034-5631
US

V. Phone/Fax

Practice location:
  • Phone: 313-247-3602
  • Fax:
Mailing address:
  • Phone: 313-247-3602
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: