Provider Demographics
NPI:1346282027
Name:DETROIT CARE CENTER ,LLC
Entity Type:Organization
Organization Name:DETROIT CARE CENTER ,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SIRAJ
Authorized Official - Middle Name:SAYED
Authorized Official - Last Name:HAQ
Authorized Official - Suffix:
Authorized Official - Credentials:BA(HONS)
Authorized Official - Phone:313-579-2462
Mailing Address - Street 1:511 E GRAND BLVD
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48207-3636
Mailing Address - Country:US
Mailing Address - Phone:313-579-2462
Mailing Address - Fax:
Practice Address - Street 1:511 E GRAND BLVD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48207-3636
Practice Address - Country:US
Practice Address - Phone:313-579-2462
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility