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General NPI Number Information
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NPI Number | 1366266678
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Entity Type | Organization
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Legal Business Name | TRANSITIONAL ADULT CARE
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Dates
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Enumeration Date | 11/13/2024
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Last Update Date | 11/13/2024
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Provider Practice Location Address
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Address Line | 31574 HAYES RD
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City | FRASER
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State | MI
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Zip | 48026-3611
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Country | US
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Telephone | 313-574-1430
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Fax |
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Provider Business Mailing Address
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Address Line | 31574 HAYES RD
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City | FRASER
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State | MI
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Zip | 48026-3611
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Country | US
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Telephone | 313-574-1430
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | VIOLET BENFORD
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Credential |
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Telephone | 313-574-1430
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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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 | 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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