Provider Demographics
NPI:1881582203
Name:STRODE, CASSANDRA Y (ADULT FOSTER CARE)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:Y
Last Name:STRODE
Suffix:
Gender:F
Credentials:ADULT FOSTER CARE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19497 CHEYENNE ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48235-1218
Mailing Address - Country:US
Mailing Address - Phone:317-965-0915
Mailing Address - Fax:
Practice Address - Street 1:16035 ALLEN RD
Practice Address - Street 2:
Practice Address - City:SOUTHGATE
Practice Address - State:MI
Practice Address - Zip Code:48195-2923
Practice Address - Country:US
Practice Address - Phone:734-258-8073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-25
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIAS820418915311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home