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General NPI Number Information
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NPI Number | 1316305154
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Entity Type | Organization
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Legal Business Name | DAVID ADAMS
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Dates
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Enumeration Date | 02/08/2016
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Last Update Date | 02/08/2016
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Provider Practice Location Address
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Address Line | 19917 FOX
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City | REDFORD
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State | MI
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Zip | 48240-1537
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Country | US
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Telephone | 313-537-7421
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Fax |
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Provider Business Mailing Address
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Address Line | 19917 FOX
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City | REDFORD
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State | MI
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Zip | 48240-1537
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Country | US
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Telephone | 313-537-7421
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. DAVID RONALD ADAMS JR.
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Credential |
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Telephone | 313-537-7421
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 6401015283
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 6401015283
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License Number State | MI
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