NPIMap

Organization Active NPI

CLW Adult Day Care Service LLC

  • Adult Day Care Clinic/Center
  • River Rouge, MI
National Provider Identifier
1497058549
Registry record updated Dec 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
Legal business name
CLW ADULT DAY CARE SERVICE LLC
Practice address
10450 W Jefferson Ave
River Rouge, MI 48218-1334
Phone
(313) 575-3573
Fax
(313) 842-0066
NPI assigned
Dec 13, 2010
Last updated
Dec 13, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Nakeysha Catherine Wisdom
Title
C.E.O
Phone
(313) 575-3573

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Day Care Clinic/Center 261QA0600X Primary

Addresses

Primary practice location

10450 W Jefferson Ave
River Rouge, MI 48218-1334

Mailing address

10450 W Jefferson Ave
River Rouge, MI 48218-1334
Phone (313) 575-3573

National Provider Directory

National Provider Directory

Locations

16838 E 8 Mile Rd
Detroit, MI 48205
Phone (313) 245-0870

10450 W Jefferson Ave
River Rouge, MI 48218
Phone (313) 575-3573

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1292198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292198400000",
    "number": "1497058549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10450 W JEFFERSON AVE",
            "city": "RIVER ROUGE",
            "state": "MI",
            "postal_code": "482181334",
            "telephone_number": "313-575-3573",
            "fax_number": "313-842-0066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10450 W JEFFERSON AVE",
            "city": "RIVER ROUGE",
            "state": "MI",
            "postal_code": "482181334",
            "telephone_number": "313-575-3573",
            "fax_number": "313-842-0066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLW ADULT DAY CARE SERVICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-13",
        "last_updated": "2010-12-13",
        "status": "A",
        "authorized_official_last_name": "WISDOM",
        "authorized_official_first_name": "NAKEYSHA",
        "authorized_official_middle_name": "CATHERINE",
        "authorized_official_title_or_position": "C.E.O",
        "authorized_official_telephone_number": "313-575-3573",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in River Rouge, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.