Healthcare Provider Details

I. General information

NPI: 1013715036
Provider Name (Legal Business Name): SKP ENTERPRIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2025
Last Update Date: 03/13/2025
Certification Date: 03/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16885 SNOWDEN ST
DETROIT MI
48235-4230
US

IV. Provider business mailing address

16885 SNOWDEN ST
DETROIT MI
48235-4230
US

V. Phone/Fax

Practice location:
  • Phone: 434-262-0052
  • 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

VIII. Authorized Official

Name: SHAPRIE PEATROSS
Title or Position: OWNER
Credential:
Phone: 494-262-0052