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General NPI Number Information
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NPI Number | 1043759442
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Entity Type | Individual
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Provider Name | JENNIFER CURTIS N/A
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Gender | Female
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Dates
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Enumeration Date | 02/17/2017
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Last Update Date | 01/18/2023
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Provider Practice Location Address
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Address Line | 2925 RUSSELL ST
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City | DETROIT
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State | MI
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Zip | 48207-4825
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Country | US
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Telephone | 313-396-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 2925 RUSSELL ST
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City | DETROIT
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State | MI
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Zip | 48207-4825
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Country | US
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Telephone | 313-396-5300
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172A00000X
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Taxonomy Name | Driver
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License Number |
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number | 464090206
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number | 464090206
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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