| Mary S Young Adults Day Care, Inc | |
|
19800 Pembroke Ave Detroit MI 48219-2145 | |
| (248) 250-4183 | |
| Not Available |
| Full Name | Mary S Young Adults Day Care, Inc |
|---|---|
| Speciality | Social Worker |
| Location | 19800 Pembroke Ave, Detroit, Michigan |
| Authorized Official Name and Position | Immaculata Osueke (DIRECTOR) |
| Authorized Official Contact | 2482504183 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mary S Young Adults Day Care, Inc 21860 Stratford St Oak Park MI 48237-2534 Ph: (248) 250-4183 | Mary S Young Adults Day Care, Inc 19800 Pembroke Ave Detroit MI 48219-2145 Ph: (248) 250-4183 |
| NPI Number | 1134848542 |
|---|---|
| Provider Enumeration Date | 08/26/2022 |
| Last Update Date | 02/28/2024 |
| Certification Date | 02/28/2024 |
| Medicare PECOS PAC ID | 0547605958 |
|---|---|
| Medicare Enrollment ID | O20240226000963 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134848542 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Michell Sandra Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518255140 PECOS PAC ID: 7810908761 Enrollment ID: I20060508000348 |
| Provider Name | Bernard Ike Onwuemelie |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295971075 PECOS PAC ID: 7315263019 Enrollment ID: I20150223001430 |
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