Organization
DERRICK'S ADULT FOSTER CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CASSANDRA L DERRICK (PRESIDENT, CEO, LICENSEE)
(248) 640-4813
Entity
Organization
Contact information
Practice address
5004 31ST ST, DETROIT, MI 48210-2537
(313) 897-3385
(248) 661-5024
Mailing address
PO BOX 252983, WEST BLOOMFIELD, MI 48325-2983
(248) 640-4813
(248) 661-5024
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
MI
Other
Enumeration date
05/31/2007
Last updated
08/22/2020
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