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Organization

PADA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. PATRICE TAYLOR LBSW, MA, LLP (PRESIDENT)
(313) 550-5030
Entity
Organization

Contact information

Practice address
17500 NORTHLAND PARK CT, SOUTHFIELD, MI 48075-4324
(248) 678-3934
Mailing address
25170 THORNDYKE ST, SOUTHFIELD, MI 48033-2941
(248) 678-3934
(248) 678-3934

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
251E00000X
Home Health Agency
Primary
MI

Other

Enumeration date
09/10/2013
Last updated
09/10/2013
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