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General NPI Number Information
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NPI Number | 1427656123
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Entity Type | Organization
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Legal Business Name | ELDER CARE SERVICES
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Dates
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Enumeration Date | 10/14/2020
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Last Update Date | 10/14/2020
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Provider Practice Location Address
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Address Line | 21650 W 11 MILE RD STE 206
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City | SOUTHFIELD
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State | MI
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Zip | 48076-3777
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Country | US
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Telephone | 248-632-3778
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Fax |
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Provider Business Mailing Address
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Address Line | 29907 SPARKLEBERRY DR
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City | SOUTHFIELD
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State | MI
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Zip | 48076-2072
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Country | US
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Telephone | 248-525-0295
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ALLYSA HAYES
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Credential | SOCIAL WORKER
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Telephone | 248-525-0295
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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