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NPI Code Detail

MEDICARE: PROLIFIC CARE PSYCHOLOGICAL & COUNSELING SERVICES

MEDICARE: PROLIFIC CARE PSYCHOLOGICAL & COUNSELING SERVICES
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
1163WH0200XHome Health Registered Nurse

General Provider Information

NPI Number : 1902621402
Entity Type Code : Organization
Provider Name (Legal Business Name) : PROLIFIC CARE PSYCHOLOGICAL & COUNSELING SERVICES
Provider Business Mailing Address
First Line : 8248 MANSFIELD ST
Second Line :
City : DETROIT
State : MI
Zip : 48228-1948
Country : US
Telephone Number : 313-980-8288
Fax Number :
Provider Business Practice Location Address
First Line : 8248 MANSFIELD ST
Second Line :
City : DETROIT
State : MI
Zip : 48228-1948
Country : US
Telephone Number : 313-980-8288
Fax Number :
Authorized Official
Title or Position : MANAGER
Name : APRIL JACKSON
Credential : COUNSELOR
Telephone Number : 313-980-8288
Provider Enumeration Date : 11/19/2024
Last Update Date : 11/19/2024

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Directions to “PROLIFIC CARE PSYCHOLOGICAL & COUNSELING SERVICES ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.