Organization
INNOVATIVE ADULT FOSTER CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MONIQUE ANDERSON (ADMINISTRATOR)
(313) 452-1977
Entity
Organization
Contact information
Practice address
16510 E 13 MILE RD, ROSEVILLE, MI 48066-7352
(313) 452-1977
Mailing address
16510 E 13 MILE RD, ROSEVILLE, MI 48066-7352
(313) 452-1977
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05
—
MI
Enumeration date
10/08/2021
Last updated
06/10/2024
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