MEDICARE: PATTERSON CARE SERVICES, 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
1	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility

General Provider Information

NPI Number	:	1902001522
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PATTERSON CARE SERVICES, INC.

Provider Business Mailing Address
First Line	:	P.O BOX 2214
Second Line	:	12 MILE RD
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48332-2214
Country	:	US
Telephone Number	:	248-855-8422
Fax Number	:	248-855-8412

Provider Business Practice Location Address
First Line	:	1467 DREW ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77700
Country	:	US
Telephone Number	:	713-739-8100
Fax Number	:	713-739-8101

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MRS. JANET PATTERSON
Credential	:
Telephone Number	:	248-789-5454

Provider Enumeration Date	:	06/15/2007
Last Update Date	:	07/10/2007

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