Provider Demographics
NPI:1366266678
Name:TRANSITIONAL ADULT CARE
Entity type:Organization
Organization Name:TRANSITIONAL ADULT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:VIOLET
Authorized Official - Middle Name:
Authorized Official - Last Name:BENFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-574-1430
Mailing Address - Street 1:31574 HAYES RD
Mailing Address - Street 2:
Mailing Address - City:FRASER
Mailing Address - State:MI
Mailing Address - Zip Code:48026-3611
Mailing Address - Country:US
Mailing Address - Phone:313-574-1430
Mailing Address - Fax:
Practice Address - Street 1:31574 HAYES RD
Practice Address - Street 2:
Practice Address - City:FRASER
Practice Address - State:MI
Practice Address - Zip Code:48026-3611
Practice Address - Country:US
Practice Address - Phone:313-574-1430
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-13
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation