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General NPI Number Information
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NPI Number | 1821506072
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Entity Type | Organization
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Legal Business Name | FREDERICKS FAMILY HOMES AFC INC
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Dates
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Enumeration Date | 01/22/2018
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Last Update Date | 01/22/2018
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Provider Practice Location Address
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Address Line | 14705 ALLEN RD
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City | SOUTHGATE
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State | MI
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Zip | 48195-2552
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Country | US
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Telephone | 734-287-8982
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Fax |
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Provider Business Mailing Address
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Address Line | 14705 ALLEN RD
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City | SOUTHGATE
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State | MI
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Zip | 48195-2552
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Country | US
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Telephone | 734-287-8982
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | SHERYL ANN ALLES
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Credential | PROVIDER
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Telephone | 734-330-6400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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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 |
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