Healthcare Provider Details

I. General information

NPI: 1154974541
Provider Name (Legal Business Name): TRACIE'S LOVING TOUCH SENIOR SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2019
Last Update Date: 07/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18273 LENORE
DETROIT MI
48219-3046
US

IV. Provider business mailing address

18273 LENORE
DETROIT MI
48219-3046
US

V. Phone/Fax

Practice location:
  • Phone: 248-943-6200
  • Fax:
Mailing address:
  • Phone: 248-943-6200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: TRACIE M. RASBERRY
Title or Position: OWNER
Credential:
Phone: 248-943-4004