Individual provider · Type 1 NPI
Lora Jean Davis, ARDMS, AFC
Adult Care Home Facility · Dearborn, MI
NPI number
1255970430
Active
Practice location
3307 Houston St
Dearborn, MI 48124-4159
Fax (313) 278-5243
Mailing address
PO Box 2977
Southfield, MI 48037-2977
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physical Disabilities Residential Treatment Facility | 320700000X | None listed |
| Mental Illness Community Based Residential Treatment Facility | 320800000X | None listed |
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X | None listed |
| Adult Care Home Facility Primary | 311ZA0620X | None listed |
Adult Care Home Facility: A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.
Another provider at this address
Other adult care home facility providers in Dearborn
About NPI 1255970430
Lora Jean Davis, ARDMS, AFC's National Provider Identifier is 1255970430, issued on Jan 5, 2020. The primary taxonomy on file is Adult Care Home Facility (311ZA0620X), and the practice location is in Dearborn, MI. The record was last updated on Feb 4, 2022.