MEDICARE: FOCUS CARE 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
1	163W00000X	Registered Nurse	4704243317	MI
2	163WH0200X	Home Health Registered Nurse	4704243317	MI

General Provider Information

NPI Number	:	1912190679
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOCUS CARE LLC

Provider Business Mailing Address
First Line	:	PO BOX 2122
Second Line	:
City	:	BELLEVILLE
State	:	MI
Zip	:	48112
Country	:	US
Telephone Number	:	734-502-4539
Fax Number	:

Provider Business Practice Location Address
First Line	:	15456 BROOKSIDE DR
Second Line	:
City	:	BELLEVILLE
State	:	MI
Zip	:	48111
Country	:	US
Telephone Number	:	734-699-2877
Fax Number	:

Authorized Official
Title or Position	:	RN OWNER
Name	:	DEBRA JEAN NELMS
Credential	:	RN
Telephone Number	:	734-699-2877

Provider Enumeration Date	:	08/24/2007
Last Update Date	:	08/24/2007

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