| Adult & Senior Activity Program | |
|
14160 E 14 Mile Rd Warren MI 48088 | |
| (313) 286-1665 | |
| Not Available |
| Full Name | Adult & Senior Activity Program |
|---|---|
| Speciality | Social Worker |
| Location | 14160 E 14 Mile Rd, Warren, Michigan |
| Authorized Official Name and Position | Lashella Savage (OWNER) |
| Authorized Official Contact | 3132861665 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Adult & Senior Activity Program 14160 E 14 Mile Rd Warren MI 48088-5701 Ph: (313) 286-1665 | Adult & Senior Activity Program 14160 E 14 Mile Rd Warren MI 48088 Ph: (313) 286-1665 |
| NPI Number | 1427549419 |
|---|---|
| Provider Enumeration Date | 05/24/2018 |
| Last Update Date | 11/16/2019 |
| Medicare PECOS PAC ID | 6406104686 |
|---|---|
| Medicare Enrollment ID | O20180803001453 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427549419 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jacqueline M Dunn-bell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558427104 PECOS PAC ID: 2466429394 Enrollment ID: I20040910001203 |
| Provider Name | Julie Shaw |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831549914 PECOS PAC ID: 6709178247 Enrollment ID: I20160701001630 |
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