Healthcare Provider Details

I. General information

NPI: 1659105179
Provider Name (Legal Business Name): ALL ABOARD SUPPORTS & SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2024
Last Update Date: 08/27/2024
Certification Date: 08/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25004 CHAMBLEY DR
SOUTHFIELD MI
48034
US

IV. Provider business mailing address

25004 CHAMBLEY SOUTHFIELD MI 48034
SOUTHFIELD MI
48034
US

V. Phone/Fax

Practice location:
  • Phone: 248-579-2791
  • Fax: 248-327-6091
Mailing address:
  • Phone: 248-224-4890
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385HR2065X
TaxonomyChild Physical Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: AKILAH DAVIS
Title or Position: OWNER
Credential:
Phone: 248-224-4890