| Opal Senior Services Llc | |
|
17610 Cornell Southfield MI 48075 | |
| (248) 395-3942 | |
| (248) 395-3759 |
| Full Name | Opal Senior Services Llc |
|---|---|
| Speciality | Social Worker |
| Location | 17610 Cornell, Southfield, Michigan |
| Authorized Official Name and Position | Pamela Lynne Byrd (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 2483953942 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Opal Senior Services Llc 17610 Cornell Southfield MI 48075 Ph: (248) 395-3942 | Opal Senior Services Llc 17610 Cornell Southfield MI 48075 Ph: (248) 395-3942 |
| NPI Number | 1144387507 |
|---|---|
| Provider Enumeration Date | 01/03/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 3870595788 |
|---|---|
| Medicare Enrollment ID | O20070206000458 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144387507 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 6801088359 (Michigan) | Primary |
| Provider Name | Pamela L Byrd |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205983574 PECOS PAC ID: 9234131145 Enrollment ID: I20070206000470 |
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