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General NPI Number Information
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NPI Number | 1275248577
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Entity Type | Organization
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Legal Business Name | DEERING STREET COMMUNITY LIVING & RESPITE CENTER LLC
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Dates
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Enumeration Date | 01/20/2023
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Last Update Date | 01/20/2023
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Provider Practice Location Address
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Address Line | 18700 DEERING ST
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City | LIVONIA
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State | MI
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Zip | 48152-3735
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Country | US
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Telephone | 248-777-0015
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Fax |
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Provider Business Mailing Address
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Address Line | 18700 DEERING ST
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City | LIVONIA
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State | MI
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Zip | 48152-3735
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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 | CREDENTIALING
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Name | SUSAN CATHERMAN
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Credential |
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Telephone | 734-223-1184
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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