Provider Demographics
NPI:1992128110
Name:LOVING HANDS ADULT DAY CARE&THERAPEUTIC CLINIC LLC
Entity type:Organization
Organization Name:LOVING HANDS ADULT DAY CARE&THERAPEUTIC CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:TERENCE
Authorized Official - Middle Name:DALE
Authorized Official - Last Name:WOOLFORK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-544-0731
Mailing Address - Street 1:1056 S PATRICIA ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48217-1230
Mailing Address - Country:US
Mailing Address - Phone:313-544-0731
Mailing Address - Fax:313-849-2763
Practice Address - Street 1:1056 S PATRICIA ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48217-1230
Practice Address - Country:US
Practice Address - Phone:313-544-0731
Practice Address - Fax:313-849-2763
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-23
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty