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General NPI Number Information
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NPI Number | 1770918641
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Entity Type | Organization
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Legal Business Name | PADA
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Dates
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Enumeration Date | 09/10/2013
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Last Update Date | 09/10/2013
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Provider Practice Location Address
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Address Line | 17500 NORTHLAND PARK CT
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City | SOUTHFIELD
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State | MI
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Zip | 48075-4324
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Country | US
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Telephone | 248-678-3934
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Fax |
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Provider Business Mailing Address
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Address Line | 25170 THORNDYKE ST
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City | SOUTHFIELD
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State | MI
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Zip | 48033-2941
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Country | US
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Telephone | 248-678-3934
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Fax | 248-678-3934
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. PATRICE TAYLOR
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Credential | LBSW, MA, LLP
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Telephone | 313-550-5030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | MI
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