Healthcare Provider Details

I. General information

NPI: 1255602793
Provider Name (Legal Business Name): BLESSED DAYZ ADULT DAY PROGRAM INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2012
Last Update Date: 09/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35744 FORD RD
WESTLAND MI
48185-3120
US

IV. Provider business mailing address

35744 FORD RD
WESTLAND MI
48185-3120
US

V. Phone/Fax

Practice location:
  • Phone: 313-505-6525
  • Fax:
Mailing address:
  • Phone: 313-505-6525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. NICOLE SHERI WILLIAMS
Title or Position: PRESIDENT
Credential:
Phone: 313-505-6525