Provider Demographics
NPI:1497951156
Name:FREDERICKS FAMILY HOMES, INC.
Entity Type:Organization
Organization Name:FREDERICKS FAMILY HOMES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATTI
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SIELAFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-287-8210
Mailing Address - Street 1:15100 NORTHLINE ROAD SUITE 200
Mailing Address - Street 2:PO BOX 1515
Mailing Address - City:SOUTHGATE
Mailing Address - State:MI
Mailing Address - Zip Code:48195
Mailing Address - Country:US
Mailing Address - Phone:734-287-8210
Mailing Address - Fax:734-287-8211
Practice Address - Street 1:15100 NORTHLINE ROAD SUITE 200
Practice Address - Street 2:
Practice Address - City:SOUTHGATE
Practice Address - State:MI
Practice Address - Zip Code:48195
Practice Address - Country:US
Practice Address - Phone:734-287-8210
Practice Address - Fax:734-287-8211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Not Answered311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home