Healthcare Provider Details

I. General information

NPI: 1689537946
Provider Name (Legal Business Name): GRANNY'S HELPERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2025
Last Update Date: 12/04/2025
Certification Date: 11/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16129 W MCNICHOLS ROAD
DETROIT MI
48235
US

IV. Provider business mailing address

16129 W MCNICHOLS ROAD
DETROIT MI
48235
US

V. Phone/Fax

Practice location:
  • Phone: 313-370-7894
  • Fax: 231-216-7861
Mailing address:
  • Phone: 313-370-7849
  • Fax: 231-216-7861

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code202K00000X
TaxonomyPhlebology Physician
License Number
License Number State

VIII. Authorized Official

Name: JIMIA STARR GREEN
Title or Position: PHLEBOTIMIST
Credential: PHLEBOTOMY
Phone: 313-370-7894