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General NPI Number Information
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NPI Number | 1679388342
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Entity Type | Organization
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Legal Business Name | CIRCUMSTANCES OF LIFE MICHIGAN, INC
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Dates
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Enumeration Date | 02/10/2025
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Last Update Date | 04/24/2025
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Provider Practice Location Address
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Address Line | 14797 ROSEMARY ST
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City | DETROIT
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State | MI
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Zip | 48213-1539
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Country | US
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Telephone | 734-552-4609
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5212
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City | DETROIT
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State | MI
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Zip | 48205-0212
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Country | US
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Telephone | 734-552-4609
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Fax |
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Authorized Official
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Title or Position | PROVIDER
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Name | MRS. KISHAWNDRIA SHANTAA JONES-MINER
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Credential |
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Telephone | 734-552-4609
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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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 | 253J00000X
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Taxonomy Name | Foster Care Agency
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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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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