Provider Demographics
NPI:1801099494
Name:RAF CARE SERVICES LCC
Entity type:Organization
Organization Name:RAF CARE SERVICES LCC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:N
Authorized Official - Last Name:NDASI
Authorized Official - Suffix:
Authorized Official - Credentials:SOCIAL WORKER
Authorized Official - Phone:248-943-0981
Mailing Address - Street 1:21776 COLONY PARK CIR
Mailing Address - Street 2:#205
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-1689
Mailing Address - Country:US
Mailing Address - Phone:248-943-0981
Mailing Address - Fax:248-358-9114
Practice Address - Street 1:21776 COLONY PARK CIR
Practice Address - Street 2:#205
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-1689
Practice Address - Country:US
Practice Address - Phone:248-943-0981
Practice Address - Fax:248-358-9114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MID13424302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization