Healthcare Provider Details

I. General information

NPI: 1811291529
Provider Name (Legal Business Name): DELIGHTFUL SENIOR CARE, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2011
Last Update Date: 01/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17572 SAN JUAN DR
DETROIT MI
48221-2641
US

IV. Provider business mailing address

17572 SAN JUAN DR
DETROIT MI
48221-2641
US

V. Phone/Fax

Practice location:
  • Phone: 313-544-0392
  • Fax:
Mailing address:
  • Phone: 313-544-0392
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311Z00000X
TaxonomyCustodial Care Facility
License Number
License Number State

VIII. Authorized Official

Name: LADONNA A TAYLOR
Title or Position: OWNER
Credential:
Phone: 313-544-0932