Healthcare Provider Details

I. General information

NPI: 1407062847
Provider Name (Legal Business Name): SAC ADULT DAY CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14200 PURITAN ST
DETROIT MI
48227-3323
US

IV. Provider business mailing address

14200 PURITAN ST
DETROIT MI
48227-3323
US

V. Phone/Fax

Practice location:
  • Phone: 313-270-2773
  • 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: MRS. FLORENCE TAYLOR PARKER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 313-270-2773