MEDICARE: JUST YOUR KIND OF HOME CARE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1023334646
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JUST YOUR KIND OF HOME CARE INC

Provider Business Mailing Address
First Line	:	9910 PLAINVIEW AVE
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48228-1332
Country	:	US
Telephone Number	:	313-273-8367
Fax Number	:

Provider Business Practice Location Address
First Line	:	9910 PLAINVIEW AVE
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48228-1332
Country	:	US
Telephone Number	:	313-273-8367
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JENNIFER GEORGE
Credential	:
Telephone Number	:	313-303-9220

Provider Enumeration Date	:	04/08/2010
Last Update Date	:	04/08/2010

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