Healthcare Provider Details

I. General information

NPI: 1457050791
Provider Name (Legal Business Name): AVOCARE HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2023
Last Update Date: 02/27/2023
Certification Date: 02/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 PARKLANE BLVD STE 525
DEARBORN MI
48126-4210
US

IV. Provider business mailing address

6 PARKLANE BLVD STE 525
DEARBORN MI
48126-4210
US

V. Phone/Fax

Practice location:
  • Phone: 810-275-1885
  • Fax:
Mailing address:
  • Phone: 810-275-1885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JOHN HILLARY
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 313-681-0060