Provider Demographics
NPI:1205172350
Name:DOWNRIVER CARE MANAGEMENT
Entity type:Organization
Organization Name:DOWNRIVER CARE MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RITA
Authorized Official - Middle Name:FAY
Authorized Official - Last Name:FERRELL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:734-671-5171
Mailing Address - Street 1:2363 W JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48183-2705
Mailing Address - Country:US
Mailing Address - Phone:734-671-5171
Mailing Address - Fax:
Practice Address - Street 1:2363 W JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:MI
Practice Address - Zip Code:48183-2705
Practice Address - Country:US
Practice Address - Phone:734-671-5171
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-18
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Single Specialty