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General NPI Number Information
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NPI Number | 1295082147
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Entity Type | Organization
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Legal Business Name | ST. RITA FAMILY SERVICES
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Dates
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Enumeration Date | 08/10/2012
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Last Update Date | 08/10/2012
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Provider Practice Location Address
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Address Line | 18210 STAMFORD ST
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City | LIVONIA
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State | MI
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Zip | 48152-3032
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Country | US
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Telephone | 248-921-5732
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Fax |
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Provider Business Mailing Address
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Address Line | 18210 STAMFORD ST
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City | LIVONIA
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State | MI
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Zip | 48152-3032
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Country | US
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Telephone | 248-921-5732
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MRS. JIHAN DAMAN
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Credential | M.S.W
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Telephone | 248-921-5732
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number | 251V00000X
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License Number State | MI
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