Healthcare Provider Details

I. General information

NPI: 1295114643
Provider Name (Legal Business Name): PEOPLE'S PLACE ADULT DAY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2015
Last Update Date: 05/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16915 LIVERNOIS AVE
DETROIT MI
48221-3058
US

IV. Provider business mailing address

6795 GLENWAY DR
W BLOOMFIELD MI
48322-3910
US

V. Phone/Fax

Practice location:
  • Phone: 313-646-2801
  • Fax:
Mailing address:
  • Phone: 313-790-4032
  • Fax: 313-931-9382

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: SHERYL CARSON
Title or Position: PRESIDENT/CEO
Credential:
Phone: 313-790-4032