Healthcare Provider Details

I. General information

NPI: 1316332927
Provider Name (Legal Business Name): BETTERWAY HOMECARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2015
Last Update Date: 07/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18350 LAHSER RD SUITE 210
DETROIT MI
48219-4326
US

IV. Provider business mailing address

PO BOX 19087 GRANDRIVER AVENUE
DETROIT MI
48219-0087
US

V. Phone/Fax

Practice location:
  • Phone: 313-493-2378
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
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
# 3
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number4704208429
License Number StateMI

VIII. Authorized Official

Name: LESLIE JACKSON
Title or Position: PRESIDENT
Credential: M.A.
Phone: 313-742-1777