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NPI Code Detail

MEDICARE: P.A.L.S., INC

MEDICARE: P.A.L.S., INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1302F00000XExclusive Provider OrganizationAS20014119MI
2302F00000XExclusive Provider OrganizationMI
3302F00000XExclusive Provider OrganizationMI

General Provider Information

NPI Number : 1669552931
Entity Type Code : Organization
Provider Name (Legal Business Name) : P.A.L.S., INC
Provider Business Mailing Address
First Line : 6500 N INKSTER RD
Second Line :
City : DEARBORN HEIGHTS
State : MI
Zip : 48127-1807
Country : US
Telephone Number : 313-561-3360
Fax Number : 313-561-3347
Provider Business Practice Location Address
First Line : 6500 N INKSTER RD
Second Line :
City : DEARBORN HEIGHTS
State : MI
Zip : 48127-1807
Country : US
Telephone Number : 313-561-3360
Fax Number : 313-561-3347
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : SANDRA J JACKSON
Credential : BSW, CSW
Telephone Number : 313-561-3360
Provider Enumeration Date : 10/17/2006
Last Update Date : 08/22/2020

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