Organization
ABUNDANT LIFE ADULT DAY PROGRAM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEVON JACKSON (PRESIDENT/CEO)
(469) 478-9247
Entity
Organization
Contact information
Practice address
19115 W 7 MILE RD, DETROIT, MI 48219-2706
(469) 478-9247
Mailing address
19115 W 7 MILE RD, DETROIT, MI 48219-2706
(469) 478-9247
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Enumeration date
05/15/2013
Last updated
11/11/2013
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