Healthcare Provider Details

I. General information

NPI: 1164350658
Provider Name (Legal Business Name): HEARTSTEAD HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41021 OLD MICHIGAN AVE TRLR 221
CANTON MI
48188-2728
US

IV. Provider business mailing address

41021 OLD MICHIGAN AVE TRLR 221
CANTON MI
48188-2728
US

V. Phone/Fax

Practice location:
  • Phone: 248-200-6168
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: SHONTASSIA D WOODS
Title or Position: OWNER
Credential:
Phone: 248-200-6168