Derrick's Adult Foster Care Inc

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

AS820281817 Issued in MI

Legal business name

DERRICK'S ADULT FOSTER CARE INC

Doing business as

Dafc

Practice address

4885 Ivanhoe St
Detroit, MI 48204-3675

Phone

(313) 915-2644

Fax

(248) 661-5024

NPI assigned

Apr 11, 2007

Organization subpart

No

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

Authorized official

Name

Cassandra L Derrick, BSHCM

Title

President, Ceo

Phone

(248) 640-4813

Specialties & licenses 1

Addresses

Other names 1

• DAFC Doing business as

Tax ID family

Dafc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Derrick's Adult Foster Care Inc

  • Adult Care Home Facility
  • Detroit, MI
  • NPI 1669674917
  NPD tax ID

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326326400000",
    "number": "1598989717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 252982",
            "city": "W BLOOMFIELD",
            "state": "MI",
            "postal_code": "483252982",
            "telephone_number": "248-640-4813",
            "fax_number": "248-661-5024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4885 IVANHOE ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482043675",
            "telephone_number": "313-915-2644",
            "fax_number": "248-661-5024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERRICK'S ADULT FOSTER CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2012-01-12",
        "status": "A",
        "authorized_official_last_name": "DERRICK",
        "authorized_official_first_name": "CASSANDRA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT, CEO",
        "authorized_official_telephone_number": "248-640-4813",
        "authorized_official_credential": "BSHCM"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "MI",
            "license": "AS820281817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DAFC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Simmone Cora Arielle Derouen
• Brittany Nicole Derr
• Carol Lynn Derr, M.A.
• Derrick Community Development & Human Services (Dcdhs)
• Marisa Leigh Derrick, CRNA
• Derrick's Adult Foster Care Inc
• Harold S Derstine, M.D.
• Brianna Paige Desa, DO
• Anand Himanshu Desai, M.D.
• Anusha Rakesh Desai

• Adult Care Home Facility in Detroit, MI
• Providers in Detroit, MI by specialty
• Adult Care Home Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2012; 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.