Healthcare Provider Details

I. General information

NPI: 1639093651
Provider Name (Legal Business Name): QUEEN TEEMA'S LOVING ARMS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9631 MCKINNEY ST
DETROIT MI
48224-2532
US

IV. Provider business mailing address

9631 MCKINNEY ST
DETROIT MI
48224-2532
US

V. Phone/Fax

Practice location:
  • Phone: 313-659-8780
  • Fax:
Mailing address:
  • Phone: 313-659-8780
  • 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: NATIMA JOHNSON
Title or Position: OWNER
Credential:
Phone: 313-659-8780