Healthcare Provider Details

I. General information

NPI: 1730516741
Provider Name (Legal Business Name): DAWN OF LOVE IN CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2013
Last Update Date: 10/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19184 RUTHERFORD ST
DETROIT MI
48235-2345
US

IV. Provider business mailing address

8068 STRATHMOOR ST
DETROIT MI
48228-2434
US

V. Phone/Fax

Practice location:
  • Phone: 313-492-8566
  • Fax:
Mailing address:
  • Phone: 313-582-4286
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: MRS. MALINDA ANN LEWIS
Title or Position: CEO/PRESIDENT
Credential:
Phone: 313-582-4286