Healthcare Provider Details

I. General information

NPI: 1417487828
Provider Name (Legal Business Name): PLEASANT CARE ADULT DAY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30308 SOUTHFIELD RD APT 60A
SOUTHFIELD MI
48076-1338
US

IV. Provider business mailing address

30308 SOUTHFIELD RD APT 60A
SOUTHFIELD MI
48076-1338
US

V. Phone/Fax

Practice location:
  • Phone: 248-342-9983
  • Fax: 248-792-9202
Mailing address:
  • Phone: 248-342-9983
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6401010693
License Number StateMI

VIII. Authorized Official

Name: MS. REBECCA MARIE LIMBAUGH
Title or Position: CO- OWNER
Credential: LLC
Phone: 248-342-9983