Organization
ACCORDIA SENIOR SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JACQUELINE MARTIN-EDWARD RN, CCM (PRESIDENT)
(248) 907-3393
Entity
Organization
Contact information
Practice address
20027 BURGESS, DETROIT, MI 48219-1367
(248) 907-3393
Mailing address
22503 GRAND RIVER AVE UNIT 19516, DETROIT, MI 48219-5025
(248) 907-3393
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
—
—
163WC0400X
Case Management Registered Nurse
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
372500000X
Chore Provider
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
VS0123503
—
MI
Enumeration date
11/13/2019
Last updated
03/26/2024
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