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General NPI Number Information
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NPI Number | 1770245656
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Entity Type | Organization
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Legal Business Name | DAY BREAK ADULT DAY CARE LLC
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Dates
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Enumeration Date | 10/08/2021
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Last Update Date | 10/08/2021
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Provider Practice Location Address
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Address Line | 18451 JAMES COUZENS FWY
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City | DETROIT
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State | MI
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Zip | 48235-2506
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Country | US
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Telephone | 248-795-9542
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Fax |
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Provider Business Mailing Address
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Address Line | 5408 HAMMERSMITH DR
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City | WEST BLOOMFIELD
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State | MI
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Zip | 48322-1451
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Country | US
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Telephone | 248-795-9542
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | BRITTANY FULTON
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Credential |
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Telephone | 248-795-9542
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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