Healthcare Provider Details

I. General information

NPI: 1366767527
Provider Name (Legal Business Name): ADDITIONAL DAY CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2010
Last Update Date: 03/31/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 WORCESTER PL
DETROIT MI
48203-5224
US

IV. Provider business mailing address

224 WORCESTER PL
DETROIT MI
48203-5224
US

V. Phone/Fax

Practice location:
  • Phone: 313-478-1537
  • Fax: 313-732-4959
Mailing address:
  • Phone: 313-478-1537
  • Fax: 313-732-4959

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: CONSTANCE PALMER
Title or Position: OWNER
Credential:
Phone: 313-478-1537