Healthcare Provider Details

I. General information

NPI: 1134782758
Provider Name (Legal Business Name): ANNIE BELL CHAMBERS MULTI SERVICE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2019
Last Update Date: 03/07/2023
Certification Date: 03/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18400 E 9 MILE RD
EASTPOINTE MI
48021-1962
US

IV. Provider business mailing address

18400 E 9 MILE RD
EASTPOINTE MI
48021-1962
US

V. Phone/Fax

Practice location:
  • Phone: 586-362-8122
  • Fax: 586-362-8126
Mailing address:
  • Phone: 586-362-8122
  • Fax: 586-362-8126

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State

VIII. Authorized Official

Name: VANESSA ANN HOLSEY
Title or Position: OWNER
Credential:
Phone: 586-362-8122