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Organization

CARSON ADULT FOSTER CARE, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JOHNNY CARSON JR. (PRESIDENT)
(313) 863-7050
Entity
Organization

Contact information

Practice address
19384 JAMES COUZENS FWY, DETROIT, MI 48235-1961
(313) 863-7050
(313) 863-1524
Mailing address
19384 JAMES COUZENS FWY, DETROIT, MI 48235-1961
(313) 863-7050
(313) 863-1524

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
AM8220009843
MI

Other

Enumeration date
10/19/2006
Last updated
08/22/2020
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