Healthcare Provider Details

I. General information

NPI: 1164541447
Provider Name (Legal Business Name): SUPPORTIVE CARE SERVICES OF MICHIGAN INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 MACK AVE
DETROIT MI
48201-2136
US

IV. Provider business mailing address

400 MACK AVE
DETROIT MI
48201-2136
US

V. Phone/Fax

Practice location:
  • Phone: 313-578-5000
  • Fax:
Mailing address:
  • Phone: 313-578-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. ROBERT CAHILL
Title or Position: SENIOR V.P. BUSINESS OPS & CFO
Credential:
Phone: 313-578-5017