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General NPI Number Information
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NPI Number | 1598036352
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Entity Type | Organization
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Legal Business Name | DOWNRIVER CARE MANAGEMENT
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Dates
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Enumeration Date | 01/25/2012
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Last Update Date | 01/25/2012
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Provider Practice Location Address
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Address Line | 22341 DONNELLY AVE
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City | BROWNSTOWN
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State | MI
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Zip | 48193-8265
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Country | US
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Telephone | 734-285-4473
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Fax |
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Provider Business Mailing Address
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Address Line | 22341 DONNELLY AVE
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City | BROWNSTOWN
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State | MI
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Zip | 48193-8265
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Country | US
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Telephone | 734-285-4473
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. RITA FAY FERRELL
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Credential | R.N.
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Telephone | 734-285-4473
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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