Provider Demographics
NPI:1154427789
Name:PREFERRED PROVIDERS, INC.
Entity type:Organization
Organization Name:PREFERRED PROVIDERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:CLELAND
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:734-213-7072
Mailing Address - Street 1:4261 PARK RD
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-9508
Mailing Address - Country:US
Mailing Address - Phone:734-213-7072
Mailing Address - Fax:734-213-7790
Practice Address - Street 1:4261 PARK RD
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-9508
Practice Address - Country:US
Practice Address - Phone:734-213-7072
Practice Address - Fax:734-213-7790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-14
Last Update Date:2015-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1154427789Medicaid