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General NPI Number Information
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NPI Number | 1366715732
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Entity Type | Organization
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Legal Business Name | STAR ADULT DAY CARE CENTER
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Dates
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Enumeration Date | 02/16/2012
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Last Update Date | 02/16/2012
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Provider Practice Location Address
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Address Line | 28975 GRAND RIVER AVE
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City | FARMINGTON HILLS
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State | MI
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Zip | 48336-5831
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Country | US
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Telephone | 248-469-7111
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Fax |
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Provider Business Mailing Address
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Address Line | 28975 GRAND RIVER
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City | FARMINGTON HILLS
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State | MI
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Zip | 48336
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Country | US
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Telephone | 248-469-7111
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Fax |
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | MRS. LIA DORINA LUCACI
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Credential | PTA
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Telephone | 248-469-7111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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