Healthcare Provider Details

I. General information

NPI: 1346282027
Provider Name (Legal Business Name): DETROIT CARE CENTER ,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

511 E GRAND BLVD
DETROIT MI
48207-3636
US

IV. Provider business mailing address

511 E GRAND BLVD
DETROIT MI
48207-3636
US

V. Phone/Fax

Practice location:
  • Phone: 313-579-2462
  • Fax:
Mailing address:
  • Phone: 313-579-2462
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: SIRAJ SAYED HAQ
Title or Position: CEO/OWNER
Credential: BA(HONS)
Phone: 313-579-2462