Provider Demographics
NPI:1720402829
Name:THE PARSANEA DAY CARE HOME LLC
Entity Type:Organization
Organization Name:THE PARSANEA DAY CARE HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEAVELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-904-3554
Mailing Address - Street 1:20255 WARD ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48235-4401
Mailing Address - Country:US
Mailing Address - Phone:248-904-3554
Mailing Address - Fax:
Practice Address - Street 1:16527 CRUSE ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48235-4004
Practice Address - Country:US
Practice Address - Phone:248-904-3554
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-10
Last Update Date:2014-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility