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General NPI Number Information
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NPI Number | 1497951156
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Entity Type | Organization
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Legal Business Name | FREDERICKS FAMILY HOMES, INC.
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Dates
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Enumeration Date | 06/21/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 15100 NORTHLINE ROAD SUITE 200
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City | SOUTHGATE
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State | MI
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Zip | 48195
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Country | US
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Telephone | 734-287-8210
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Fax | 734-287-8211
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Provider Business Mailing Address
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Address Line | 15100 NORTHLINE ROAD SUITE 200 PO BOX 1515
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City | SOUTHGATE
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State | MI
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Zip | 48195
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Country | US
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Telephone | 734-287-8210
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Fax | 734-287-8211
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Authorized Official
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Title or Position | FINANCIAL DIRECTOR
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Name | MRS. PATTI ANN SIELAFF
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Credential |
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Telephone | 734-287-8210
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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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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