Healthcare Provider Details

I. General information

NPI: 1447883194
Provider Name (Legal Business Name): KATHELENES ADULT DAY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2020
Last Update Date: 03/13/2025
Certification Date: 03/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21100 OSMUS ST
FARMINGTON HILLS MI
48336
US

IV. Provider business mailing address

33228 W 12 MILE RD STE 361
FARMINGTON HILLS MI
48334-3309
US

V. Phone/Fax

Practice location:
  • Phone: 248-313-2275
  • Fax: 248-313-2274
Mailing address:
  • Phone: 248-313-2275
  • Fax: 248-313-2274

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MS. TEBERAH ALEXANDER
Title or Position: PRESIDENT
Credential: RN BSN
Phone: 248-313-2275