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General NPI Number Information
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NPI Number | 1811291529
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Entity Type | Organization
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Legal Business Name | DELIGHTFUL SENIOR CARE, LLC.
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Dates
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Enumeration Date | 01/10/2011
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Last Update Date | 01/10/2011
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Provider Practice Location Address
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Address Line | 17572 SAN JUAN DR
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City | DETROIT
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State | MI
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Zip | 48221-2641
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Country | US
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Telephone | 313-544-0392
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Fax |
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Provider Business Mailing Address
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Address Line | 17572 SAN JUAN DR
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City | DETROIT
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State | MI
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Zip | 48221-2641
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Country | US
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Telephone | 313-544-0392
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LADONNA A TAYLOR
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Credential |
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Telephone | 313-544-0932
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311Z00000X
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Taxonomy Name | Custodial Care Facility
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License Number |
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License Number State |
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