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General NPI Number Information
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NPI Number | 1457996449
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Entity Type | Organization
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Legal Business Name | ACCORDIA SENIOR SERVICES
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Dates
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Enumeration Date | 11/13/2019
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Last Update Date | 03/26/2024
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Provider Practice Location Address
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Address Line | 20027 BURGESS
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City | DETROIT
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State | MI
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Zip | 48219-1367
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Country | US
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Telephone | 248-907-3393
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Fax |
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Provider Business Mailing Address
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Address Line | 22503 GRAND RIVER AVE UNIT 19516
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City | DETROIT
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State | MI
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Zip | 48219-5025
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Country | US
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Telephone | 248-907-3393
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. JACQUELINE MARTIN-EDWARD
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Credential | RN, CCM
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Telephone | 248-907-3393
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 372500000X
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Taxonomy Name | Chore Provider
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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