Provider Demographics
NPI:1154949881
Name:ADULTCARE OF INDEPENDENCE TOWNSHIP
Entity type:Organization
Organization Name:ADULTCARE OF INDEPENDENCE TOWNSHIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SUNIL
Authorized Official - Middle Name:RAMCHANDRA
Authorized Official - Last Name:BHATTAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-394-0734
Mailing Address - Street 1:8541 N ESTON RD
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48348-3509
Mailing Address - Country:US
Mailing Address - Phone:248-394-0734
Mailing Address - Fax:248-394-0643
Practice Address - Street 1:8541 N ESTON RD
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:MI
Practice Address - Zip Code:48348-3509
Practice Address - Country:US
Practice Address - Phone:248-394-0734
Practice Address - Fax:248-394-0643
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-09
Last Update Date:2020-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility