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General NPI Number Information
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NPI Number | 1013771351
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Entity Type | Organization
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Legal Business Name | COLLINS ADULT DAY CARE 24HR. OUT OF HOME RESPITE
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Dates
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Enumeration Date | 02/07/2024
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Last Update Date | 02/07/2024
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Provider Practice Location Address
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Address Line | 1201 GREENWOOD AVE
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City | JACKSON
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State | MI
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Zip | 49203
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Country | US
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Telephone | 517-539-5169
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Fax |
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Provider Business Mailing Address
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Address Line | 1201 GREENWOOD AVE
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City | JACKSON
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State | MI
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Zip | 49203
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | MECHELLE RENEE PALMER
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Credential | HIGH SCHOOL DIMPLOMA
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Telephone | 517-539-5169
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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