Healthcare Provider Details

I. General information

NPI: 1053231225
Provider Name (Legal Business Name): KINDRED-CONNECT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4220 GLENDALE ST
DETROIT MI
48238-3212
US

IV. Provider business mailing address

4220 GLENDALE ST
DETROIT MI
48238-3212
US

V. Phone/Fax

Practice location:
  • Phone: 313-502-0134
  • Fax:
Mailing address:
  • Phone: 313-502-0134
  • 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: DESTINEE WILLIAMS
Title or Position: OWNER
Credential:
Phone: 313-502-0134