Healthcare Provider Details

I. General information

NPI: 1184375529
Provider Name (Legal Business Name): PLYMOUTH SENIOR SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2022
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2050 N. HAGGERTY RD. STE 170
CANTON MI
48187
US

IV. Provider business mailing address

2050 N. HAGGERTY RD. STE 170
CANTON MI
48187
US

V. Phone/Fax

Practice location:
  • Phone: 734-414-1981
  • Fax:
Mailing address:
  • Phone: 734-414-1981
  • Fax: 734-414-1983

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: VIRGINIA IRWIN
Title or Position: PRESIDENT
Credential:
Phone: 734-414-1981