Healthcare Provider Details

I. General information

NPI: 1801352984
Provider Name (Legal Business Name): ASSISTED CARE SOLUTION INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2019
Last Update Date: 06/14/2021
Certification Date: 08/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19976 WARD ST
DETROIT MI
48235-1139
US

IV. Provider business mailing address

162 BELLE VILLA BLVD
BELLEVILLE MI
48111-4906
US

V. Phone/Fax

Practice location:
  • Phone: 313-414-6166
  • Fax:
Mailing address:
  • Phone: 313-414-6166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: LAKISHA SHONTA HUMBER
Title or Position: CEO
Credential:
Phone: 313-414-6166