Healthcare Provider Details

I. General information

NPI: 1376315432
Provider Name (Legal Business Name): LOUISE SENIOR CARE AGENCY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2023
Last Update Date: 10/23/2023
Certification Date: 10/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12758 SANTA ROSA DR
DETROIT MI
48238-4204
US

IV. Provider business mailing address

12758 SANTA ROSA DR
DETROIT MI
48238-4204
US

V. Phone/Fax

Practice location:
  • Phone: 313-397-7399
  • Fax:
Mailing address:
  • Phone: 313-397-7399
  • 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 Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: MS. FELITA RAMSEY
Title or Position: CAREGIVER
Credential:
Phone: 313-397-7399