Healthcare Provider Details

I. General information

NPI: 1851957096
Provider Name (Legal Business Name): LOVING HEARTS ADULT DAY CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2019
Last Update Date: 05/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24421 W 9 MILE RD
SOUTHFIELD MI
48033-3976
US

IV. Provider business mailing address

24421 W 9 MILE RD
SOUTHFIELD MI
48033-3976
US

V. Phone/Fax

Practice location:
  • Phone: 313-850-0271
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JAMESHA WILLIAMS
Title or Position: ADMINISTRATOR
Credential:
Phone: 313-850-0271