Healthcare Provider Details

I. General information

NPI: 1417828526
Provider Name (Legal Business Name): BENEVOLENT HEARTS SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2025
Last Update Date: 09/13/2025
Certification Date: 09/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18200 NARDY ST
CLINTON TOWNSHIP MI
48036-1762
US

IV. Provider business mailing address

18200 NARDY ST
CLINTON TOWNSHIP MI
48036-1762
US

V. Phone/Fax

Practice location:
  • Phone: 313-657-2898
  • 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 Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. LISA EDWARDS
Title or Position: OWNER
Credential: RN
Phone: 313-657-2898