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Organization

MAAN DOWN LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
VACERA MAKIBA MACK COTA (CHIEF ADMINISTRATIVE OFFICER)
(586) 572-7444
Entity
Organization

Contact information

Practice address
16885 ILENE ST, DETROIT, MI 48221
(586) 932-7087
Mailing address
20830 LANTZ ST, CLINTON TOWNSHIP, MI 48035-2732
(586) 457-2744

Taxonomy

Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
E78238
MI
311ZA0620X
Adult Care Home Facility
E78238
MI

Other

Enumeration date
09/07/2016
Last updated
08/23/2018
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