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Organization
TENDERCARE
Active
Organization
TENDERCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIMBERLY ANN HALL COTA/L (CERTIFIED OCCUPATIONAL THERAPY ASST)
(313) 671-6231
Entity
Organization
Contact information
Practice address
19300 WHERLE DR, BROWNSTOWN, MI 48193-8530
(313) 671-6231
Mailing address
22950 NORTHLINE RD, TAYLOR, MI 48180-4696
(734) 287-1230
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5202002761
BOARD OF OCCUPATIONAL THERAPIST OCCUPATIONAL THERAPY ASSISTANT LICENSE
MI
Enumeration date
12/11/2013
Last updated
12/11/2013
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