Provider Demographics
NPI:1215172440
Name:PERSONALIZED ASSISTANCE LIVING SERVICES
Entity type:Organization
Organization Name:PERSONALIZED ASSISTANCE LIVING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXE. DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PENNY
Authorized Official - Middle Name:ARLINE
Authorized Official - Last Name:DOMBROWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:734-975-0610
Mailing Address - Street 1:3924 TRADE CENTER DR
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-2072
Mailing Address - Country:US
Mailing Address - Phone:734-975-0610
Mailing Address - Fax:734-975-0610
Practice Address - Street 1:3924 TRADE CENTER DR
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-2072
Practice Address - Country:US
Practice Address - Phone:734-975-0610
Practice Address - Fax:734-975-0610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-02
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care