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General NPI Number Information
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NPI Number | 1912402629
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Entity Type | Organization
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Legal Business Name | NEW SEASONS ADULT SERVICES, LLC
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Dates
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Enumeration Date | 03/26/2018
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Last Update Date | 03/26/2018
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Provider Practice Location Address
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Address Line | 1035 E. CARPENTER ROAD
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City | FLINT
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State | MI
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Zip | 48505
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Country | US
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Telephone | 810-449-4038
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Fax |
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Provider Business Mailing Address
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Address Line | 1035 E. CARPENTER ROAD
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City | FLINT
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State | MI
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Zip | 48505
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Country | US
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Telephone | 810-449-4038
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | ROCHELL HARPER-SHELTON
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Credential | MSA
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Telephone | 810-449-4038
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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 | MI
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