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General NPI Number Information
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NPI Number | 1205172350
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Entity Type | Organization
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Legal Business Name | DOWNRIVER CARE MANAGEMENT
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Dates
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Enumeration Date | 12/18/2012
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Last Update Date | 12/18/2012
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Provider Practice Location Address
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Address Line | 2363 W JEFFERSON AVE
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City | TRENTON
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State | MI
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Zip | 48183-2705
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Country | US
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Telephone | 734-671-5171
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Fax |
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Provider Business Mailing Address
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Address Line | 2363 W JEFFERSON AVE
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City | TRENTON
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State | MI
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Zip | 48183-2705
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Country | US
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Telephone | 734-671-5171
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | RITA FAY FERRELL
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Credential | R.N.
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Telephone | 734-671-5171
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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