DERRICK'S ADULT FOSTER CARE INC (NPI# 1669674917) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669674917 |
| Entity Type | Organization |
| Organization Name | DERRICK'S ADULT FOSTER CARE INC |
| Practice Address |
5004 31st St Detroit MI 48210-2537 |
| Mailing Address |
Po Box 252983 West Bloomfield MI 48325-2983 |
| Practice Telephone | 3138973385 |
| Practice Fax Number | 2486615024 |
| Mailing Telephone | 2486404813 |
| Mailing Fax Number | 2486615024 |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | CASSANDRA L DERRICK (PRESIDENT, CEO, LICENSEE) |
| Authorized Official Telephone | 2486404813 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
MI | Nursing & Custodial Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598989717 | Derrick's Adult Foster Care Inc | Custodial Care Facility | 4885 Ivanhoe St, Detroit, MI 48204-3675 | 2007-04-11 |
| Street Address |
5004 31ST ST |
| City | DETROIT |
| State | MI |
| Zip Code | 48210-2537 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518517606 | Southwest Solutions | Counselor | 5716 Michigan, Detroit, MI 48210 | 2019-09-19 |
| 1942676150 | Audrey Hall | Case Manager/Care Coordinator | 6576 Woodrow St, Detroit, MI 48210 | 2015-08-12 |
| 1952705147 | Barbara Denise Mccowin-west | Technician, Other | 6900 Mcgraw, Detroit, MI 48210 | 2014-10-16 |
| 1922259456 | Dawn Marie Sanderson | Counselor | 5613 Livernois, Detroit, MI 48210 | 2008-10-02 |
| 1366552804 | American Indian Health and Family Services of Southeastern Mi Inc | In Home Supportive Care | 4880 Lawndalestreet, Detroit, MI 48210 | 2006-08-30 |
| 1912950163 | Irwin Rabinowitz | Pharmacist | Junction Clinic Pharmacy 4771 Michigan Ave., Detroit, MI 48210 | 2006-05-18 |
| 1295229110 | Anne Marie Galus | Dentist | 5716 Michigan Ave, Detroit, MI 48210 | 2018-06-15 |
| 1124547948 | Sarah Fay Walsworth | Physician Assistant | 5716 Michigan Ave, Detroit, MI 48210 | 2017-09-13 |
| 1538305909 | Barbara Ann Menzies-williams | Internal Medicine | 6550 W Warren Ave, Detroit, MI 48210 | 2009-01-06 |
| 1760678437 | Clement T Piaskowski | Optometrist | 7433 Michigan Ave, Detroit, MI 48210 | 2007-09-17 |
| Find all providers in zip 48210 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
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| 1790397594 | St. Ruth's House of Hope LLC | Custodial Care Facility | 3100 S Electric St, Detroit, MI 48217-1133 | 2020-08-21 |
| 1558837229 | New Center Inn Company | Custodial Care Facility | 158 Pingree St, Detroit, MI 48202-2022 | 2018-10-19 |
| 1477029700 | Acon Services, Inc. | Custodial Care Facility | 17126 Prevost St, Detroit, MI 48235-3551 | 2018-10-14 |
| 1619452588 | Hudson Home 1 Inc | Custodial Care Facility | 750 Virginia Park St, Detroit, MI 48202-2033 | 2018-09-26 |
| 1578083077 | New Advantage Inc. | Custodial Care Facility | 15375 Ardmore St, Detroit, MI 48227-3222 | 2017-06-26 |
| 1003348145 | Reality Response LLC | Custodial Care Facility | 2455 W Grand St, Detroit, MI 48238-3445 | 2017-03-29 |
| 1376080614 | Crystal Serenity House | Custodial Care Facility | 14241 Faust Ave Ste 200-b, Detroit, MI 48223-3574 | 2017-01-25 |
| 1225585250 | Maan Down LLC | Custodial Care Facility | 16885 Ilene St, Detroit, MI 48221 | 2016-09-07 |
| 1881051712 | Tasha Harris | Custodial Care Facility | 6402 Penrod St, Detroit, MI 48228-4748 | 2016-01-22 |
| Find all providers in DETROIT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.