Healthcare Provider Details

I. General information

NPI: 1285353573
Provider Name (Legal Business Name): ROBBIN LARKIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2022
Last Update Date: 08/22/2022
Certification Date: 08/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1485 E OUTER DR
DETROIT MI
48234-1265
US

IV. Provider business mailing address

1485 E OUTER DR
DETROIT MI
48234-1265
US

V. Phone/Fax

Practice location:
  • Phone: 313-759-4368
  • Fax:
Mailing address:
  • Phone:
  • 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: