1164462305 NPI number — STANDARD CARE, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164462305 NPI number — STANDARD CARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
STANDARD CARE, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1164462305
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
500 RIVER PLACE DR
Provider Second Line Business Mailing Address:
5156
Provider Business Mailing Address City Name:
DETROIT
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48207-5030
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-595-2944
Provider Business Mailing Address Fax Number:
313-567-6309

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
500 RIVER PLACE DR.
Provider Second Line Business Practice Location Address:
5156
Provider Business Practice Location Address City Name:
DETROIT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48207-5048
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
313-567-1918
Provider Business Practice Location Address Fax Number:
313-567-6309
Provider Enumeration Date:
06/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
FRANK
Authorized Official First Name:
DEMETRIUS
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
313-401-4548

Provider Taxonomy Codes

  • Taxonomy code: 332BC3200X , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 4695257 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com