Provider Demographics
NPI:1801154943
Name:PETER RABBIT DAY CARE CENTER INC
Entity type:Organization
Organization Name:PETER RABBIT DAY CARE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BERNITA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAVARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-882-7446
Mailing Address - Street 1:5901 CADIEUX RD
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48224-2003
Mailing Address - Country:US
Mailing Address - Phone:313-882-7446
Mailing Address - Fax:
Practice Address - Street 1:5901 CADIEUX RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48224-2003
Practice Address - Country:US
Practice Address - Phone:313-882-7446
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-26
Last Update Date:2012-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X, 225XP0200X, 2251P0200X
MI8200017384171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty