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General NPI Number Information
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NPI Number | 1922509884
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Entity Type | Organization
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Legal Business Name | VILLAGE OF HOPE SENIOR CENTER
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Dates
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Enumeration Date | 02/26/2018
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Last Update Date | 02/26/2018
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Provider Practice Location Address
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Address Line | 3127 E CANFIELD ST
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City | DETROIT
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State | MI
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Zip | 48207-1508
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Country | US
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Telephone | 313-459-1869
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Fax |
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Provider Business Mailing Address
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Address Line | 23041 ONEIDA ST
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City | OAK PARK
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State | MI
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Zip | 48237-2227
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | LATONYA RICHARDSON BROWN
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Credential |
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Telephone | 313-458-1869
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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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 | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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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 |
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