Healthcare Provider Details

I. General information

NPI: 1811273030
Provider Name (Legal Business Name): DOWNRIVERS NEST ADULT DAY HEALTH CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2011
Last Update Date: 11/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24354 ECORSE RD
TAYLOR MI
48180-1643
US

IV. Provider business mailing address

24354 ECORSE RD
TAYLOR MI
48180-1643
US

V. Phone/Fax

Practice location:
  • Phone: 313-292-5300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number StateMI

VIII. Authorized Official

Name: MR. JONATHAN BARNETT II
Title or Position: BUSINESS MANAGER
Credential:
Phone: 313-292-5300