Healthcare Provider Details

I. General information

NPI: 1124253745
Provider Name (Legal Business Name): TYCIO ENTERPRISES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2009
Last Update Date: 05/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 GREEN CT SUITE 140
ANN ARBOR MI
48105-1570
US

IV. Provider business mailing address

3600 GREEN CT SUITE 140
ANN ARBOR MI
48105-1570
US

V. Phone/Fax

Practice location:
  • Phone: 734-302-4215
  • Fax: 734-302-4217
Mailing address:
  • Phone: 734-302-4215
  • Fax: 734-302-4217

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateMI

VIII. Authorized Official

Name: MR. MICHAEL EDWARD PRICE
Title or Position: OWNER/PRESIDENT
Credential:
Phone: 734-302-4215