Healthcare Provider Details

I. General information

NPI: 1285469312
Provider Name (Legal Business Name): CHICARES ASSISTED LIVING LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2024
Last Update Date: 09/06/2024
Certification Date: 09/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10012 ROBSON ST
DETROIT MI
48227-2471
US

IV. Provider business mailing address

46908 WAREHAM
CANTON MI
48187-4673
US

V. Phone/Fax

Practice location:
  • Phone: 313-408-3227
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3104A0625X
TaxonomyAssisted Living Facility (Mental Illness)
License Number
License Number State

VIII. Authorized Official

Name: VINCENT ANWUNAH
Title or Position: PRESIDENT
Credential:
Phone: 313-613-9203