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General NPI Number Information
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NPI Number | 1992640031
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Entity Type | Organization
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Legal Business Name | AFFLUENT ADULT FOSTER CARE
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Dates
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Enumeration Date | 04/23/2026
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Last Update Date | 04/23/2026
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Provider Practice Location Address
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Address Line | 18885 HELEN ST
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City | DETROIT
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State | MI
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Zip | 48234-3014
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Country | US
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Telephone | 248-416-3176
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 361272
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City | GROSSE POINTE
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State | MI
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Zip | 48236-5272
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Country | US
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Telephone | 248-416-3176
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | JOHN K BRYANT
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Credential |
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Telephone | 248-416-3176
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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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 | 3104A0625X
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Taxonomy Name | Assisted Living Facility (Mental Illness)
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License Number |
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License Number State |
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