Healthcare Provider Details

I. General information

NPI: 1275192247
Provider Name (Legal Business Name): GREATER METRO DETROIT SENIOR ASSISTANCE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2019
Last Update Date: 04/06/2023
Certification Date: 04/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6060 DIXIE HWY STE E
CLARKSTON MI
48346-3476
US

IV. Provider business mailing address

6060 DIXIE HWY STE E
CLARKSTON MI
48346-3476
US

V. Phone/Fax

Practice location:
  • Phone: 248-623-7999
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: KYLE KASLER
Title or Position: DIRECTOR
Credential:
Phone: 248-623-7999