1780250357 NPI number — ADAMS & PARKS ENTERPRISES INC

Table of content: (NPI 1780250357)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780250357 NPI number — ADAMS & PARKS ENTERPRISES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADAMS & PARKS ENTERPRISES 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:
6
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:
1780250357
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/28/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4200 EMERALD DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRIDGEPORT
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48722-9520
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
989-890-1659
Provider Business Mailing Address Fax Number:
989-900-0746

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4200 EMERALD DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRIDGEPORT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48722-9520
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
989-890-1659
Provider Business Practice Location Address Fax Number:
989-900-0746
Provider Enumeration Date:
06/03/2021

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
PARKS
Authorized Official First Name:
LAKISHA
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
989-890-1659

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 7883754 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".