NPI 1043990666
Jcreative3000
Practice location
- Address
- 3201 S Edsel St, Detroit, MI 48217-2405
- Phone
- (586) 625-9704
Authorised official
- Name
- Jacqueline Sproles
- Title
- Administrator
- Phone
- (586) 625-9704
Registered specialties
Nursing Home Administrator
Primary
Registry record
- NPI
- 1043990666
- Entity type
- Organization
- NPI issued
- 19 Jul 2023
- Record last updated
- 19 Jul 2023
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.