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NPI Code Detail

MEDICARE: DOWNRIVER HEALTH LLC

MEDICARE: DOWNRIVER HEALTH LLC
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
13747P1801XPersonal Care Attendant
2253Z00000XIn Home Supportive Care Agency

General Provider Information

NPI Number : 1679378004
Entity Type Code : Organization
Provider Name (Legal Business Name) : DOWNRIVER HEALTH LLC
Provider Business Mailing Address
First Line : 33026 WEST RD
Second Line :
City : NEW BOSTON
State : MI
Zip : 48164-9706
Country : US
Telephone Number : 734-686-9847
Fax Number :
Provider Business Practice Location Address
First Line : 33026 WEST RD
Second Line :
City : NEW BOSTON
State : MI
Zip : 48164-9706
Country : US
Telephone Number : 734-686-9847
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DANIEL SOUDER
Credential :
Telephone Number : 734-686-9847
Provider Enumeration Date : 02/18/2025
Last Update Date : 03/12/2026

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