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General NPI Number Information
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NPI Number | 1336939214
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Entity Type | Organization
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Legal Business Name | PRENTIS LOFT LLC
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Dates
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Enumeration Date | 05/12/2025
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Last Update Date | 05/19/2025
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Provider Practice Location Address
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Address Line | 2143 HARDING ST
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City | DETROIT
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State | MI
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Zip | 48214-3126
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Country | US
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Telephone | 313-332-0143
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Fax |
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Provider Business Mailing Address
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Address Line | 2147 HARDING ST
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City | DETROIT
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State | MI
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Zip | 48214-3126
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Country | US
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Telephone | 313-333-5192
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JAMES SPENCER MCNEARY
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Credential | MBA
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Telephone | 313-333-5192
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311Z00000X
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Taxonomy Name | Custodial Care Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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