Provider Demographics
NPI:1528463023
Name:GOLDEN YEARS ADULT DAY CARE& THERAPEUTIC CLINIC INC
Entity type:Organization
Organization Name:GOLDEN YEARS ADULT DAY CARE& THERAPEUTIC CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CANDICE
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-535-9891
Mailing Address - Street 1:19115 W 8 MILE RD
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48219-1400
Mailing Address - Country:US
Mailing Address - Phone:313-535-9891
Mailing Address - Fax:313-535-9896
Practice Address - Street 1:19115 W 8 MILE RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48219-1400
Practice Address - Country:US
Practice Address - Phone:313-535-9891
Practice Address - Fax:313-535-9896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-27
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty