Individual provider · NPI-1

Caprice Mckinnon

Clinic/Center, Adult Day Care · Farmington Hills, MI

NPI number1154914810

StatusActive

Last updated in NPPESFeb 13, 2021

Details

NPI: 1154914810
Entity type: Individual (NPI-1)
Name: Caprice Mckinnon
Sex: Female
Sole proprietor: Yes
Enumeration date: Feb 13, 2021
Certification date: Feb 13, 2021
Last updated: Feb 13, 2021

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
261QA0600X	Clinic/Center, Adult Day Care	–	–	Yes
251T00000X	PACE Provider Organization	–	–
261QR0800X	Clinic/Center, Recovery Care	–	–
310400000X	Assisted Living Facility	–	–
311ZA0620X	Custodial Care Facility, Adult Care Home	–	–
332B00000X	Durable Medical Equipment & Medical Supplies	–	–
343900000X	Non-emergency Medical Transport (VAN)	–	–
3747P1801X	Technician, Personal Care Attendant	–	–
374U00000X	Home Health Aide	–	–
385H00000X	Respite Care	–	–

Practice location

32255 W 12 Mile Rd Apt 6
Farmington Hills, MI 48334-3560

Phone 248-579-3416

Mailing address

29155 Northwestern Hwy Ste 632
Southfield, MI 48034-1011

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