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NPI 1891745808

NPI 1891745808 : PEDIATRIC SPECIAL CARE, INC. : NORTHVILLE, MI

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General NPI Number Information
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    NPI Number           |    1891745808
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    Entity Type          |    Organization 
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    Legal Business Name  |    PEDIATRIC SPECIAL CARE, INC. 
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Dates
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    Enumeration Date     |    05/11/2006
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    Last Update Date     |    01/27/2025
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Provider Practice Location Address
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    Address Line         |    22260 HAGGERTY RD STE 180 
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    City                 |    NORTHVILLE
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    State                |    MI
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    Zip                  |    48167-8984
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    Country              |    US
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    Telephone            |    248-557-4800
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    Fax                  |    248-557-3998
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Provider Business Mailing Address
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    Address Line         |    400 INTERSTATE NORTH PKWY SE STE 1600 
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    City                 |    ATLANTA
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    State                |    GA
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    Zip                  |    30339-5047
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    Country              |    US
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    Telephone            |    470-464-8000
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    Fax                  |    
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Authorized Official
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    Title or Position    |    CFO
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    Name                 |     MATTHEW  BUCKHALTER 
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    Credential           |    
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    Telephone            |    470-464-8000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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    Taxonomy Code        |    251J00000X
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    Taxonomy Name        |    Nursing Care Agency
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    License Number       |    
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    License Number State |    
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