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Agencies Home Health

Provider NPI: 1215405626

Organization Information:
Organization is not Subpart
Authorized Official:  MONIQUE  TAYLOR  PROGRAM MANAGER  248-632-2560

Practice Location:
21246 WESTVIEW AVE  FERNDALE, MI 48220-2268 US
Tel: 248-632-2560  Fax: --

Business Mailing Address:
21246 WESTVIEW AVE  FERNDALE, MI 48220-2268 US
Tel: 248-632-2560  Fax: --

NPI Information:
NPI: 1215405626
Entity Type: Organization


PrimaryCodeCategory/DescriptionStateLicense Number
Home Health
Nursing Care
Foster Care Agency
N261QM0855XAmbulatory Health Care Facilities
N261QS1000XAmbulatory Health Care Facilities
N310400000XNursing & Custodial Care Facilities
Assisted Living Facility
Y322D00000XResidential Treatment Facilities
Residential Treatment Facility, Emotionally Disturbed Children

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 322D00000X





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