Healthcare Provider Details

I. General information

NPI: 1336924174
Provider Name (Legal Business Name): NEXUS HEALTH AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2023
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15380 MONICA ST
DETROIT MI
48238-1942
US

IV. Provider business mailing address

15380 MONICA ST
DETROIT MI
48238-1942
US

V. Phone/Fax

Practice location:
  • Phone: 248-701-8426
  • Fax:
Mailing address:
  • Phone: 248-701-8426
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LATOYA WEST
Title or Position: RCM MANAGER
Credential:
Phone: 734-345-9023