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General NPI Number Information
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NPI Number | 1669833455
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Entity Type | Organization
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Legal Business Name | TAYLOR SPECIAL CARE SERVICES
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Dates
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Enumeration Date | 03/08/2016
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Last Update Date | 03/29/2016
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Provider Practice Location Address
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Address Line | 23800 W 10 MILE RD SUITE 210
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City | SOUTHFIELD
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State | MI
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Zip | 48033-3176
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Country | US
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Telephone | 248-350-0357
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Fax |
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Provider Business Mailing Address
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Address Line | 23800 W 10 MILE RD SUITE 210
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City | SOUTHFIELD
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State | MI
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Zip | 48033-3176
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Country | US
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Telephone | 248-350-0357
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | SHERMAN TAYLOR
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Credential |
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Telephone | 248-350-0357
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number | AS630313908
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State | MI
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