Healthcare Provider Details
I. General information
NPI: 1083173017
Provider Name (Legal Business Name): NEWPORT CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/19/2019
Last Update Date: 03/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
22977 NEWPORT ST
SOUTHFIELD MI
48075-5850
US
IV. Provider business mailing address
30066 PONDSVIEW DR
FRANKLIN MI
48025-1524
US
V. Phone/Fax
- Phone: 248-353-7818
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 320700000X |
| Taxonomy | Physical Disabilities Residential Treatment Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
ARTESIA
MCNEAL WASHINGTON
Title or Position: PRESIDENT
Credential:
Phone: 248-539-9055