Jacquelyn Kelly Hudson
Assisted Living Facility in Detroit, MI. Individual provider (NPI-1).
NPI number1861284572
StatusActive
Last updated in NPPESMay 19, 2025
Details
- NPI
- 1861284572
- Entity type
- Individual (NPI-1)
- Name
- Jacquelyn Kelly Hudson
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- May 19, 2025
- Certification date
- May 19, 2025
- Last updated
- May 19, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 310400000X | Assisted Living Facility | R312086 | MI | Yes |
Practice location
20549 Stout StDetroit, MI 48219-1428
Phone 313-766-5846
Mailing address
5477 S. Piccadilly CircleWest Bloomfield, MI 48322-1446
Phone 248-752-2077
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 19 Assisted Living Facility providers in Detroit · All 25,238 providers in Detroit
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