Organization
A SENIOR PROMISE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SANDRA SMITH (CEO)
(313) 656-7105
Entity
Organization
Contact information
Practice address
26812 FAIRFIELD RD, SOUTHFIELD, MI 48076-4714
(313) 656-7105
Mailing address
26812 FAIRFIELD RD, SOUTHFIELD, MI 48076-4714
(313) 656-7105
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/08/2012
Last updated
11/08/2012
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