Provider Demographics
NPI:1548609902
Name:SENIOR CARE ALTERNATIVES PLLC
Entity Type:Organization
Organization Name:SENIOR CARE ALTERNATIVES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KWESI
Authorized Official - Middle Name:O
Authorized Official - Last Name:MCGILL
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:734-315-0606
Mailing Address - Street 1:25 BROOKLINE LN
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48120-1037
Mailing Address - Country:US
Mailing Address - Phone:734-315-0606
Mailing Address - Fax:
Practice Address - Street 1:25 BROOKLINE LN
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48120-1037
Practice Address - Country:US
Practice Address - Phone:734-315-0606
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-19
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010907371041C0700X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty