Healthcare Provider Details

I. General information

NPI: 1528953734
Provider Name (Legal Business Name): HAYDEN'S HEALING HANDS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19959 RIOPELLE ST
DETROIT MI
48203-1249
US

IV. Provider business mailing address

14984 RIVER VIEW CT
STERLING HEIGHTS MI
48313-5772
US

V. Phone/Fax

Practice location:
  • Phone: 586-980-0090
  • Fax: 586-980-0090
Mailing address:
  • Phone: 586-980-0090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3104A0630X
TaxonomyAssisted Living Facility (Behavioral Disturbances)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: SHAFONTA HAYDEN
Title or Position: OWNER
Credential:
Phone: 586-980-0090