Provider Demographics
NPI:1144694522
Name:SUPERIOR CARE ADULT DAY PROGRAM
Entity type:Organization
Organization Name:SUPERIOR CARE ADULT DAY PROGRAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTHCARE PROVIDER
Authorized Official - Prefix:MS
Authorized Official - First Name:OSARETIN
Authorized Official - Middle Name:
Authorized Official - Last Name:UWAIFO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-478-1374
Mailing Address - Street 1:17471 OLYMPIA
Mailing Address - Street 2:
Mailing Address - City:REDFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48240-2141
Mailing Address - Country:US
Mailing Address - Phone:313-478-1374
Mailing Address - Fax:
Practice Address - Street 1:17471 OLYMPIA
Practice Address - Street 2:
Practice Address - City:REDFORD
Practice Address - State:MI
Practice Address - Zip Code:48240-2141
Practice Address - Country:US
Practice Address - Phone:313-478-1374
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-22
Last Update Date:2015-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home