Healthcare Provider Details

I. General information

NPI: 1750263257
Provider Name (Legal Business Name): PCT HOME HELP ANGENCY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2025
Last Update Date: 07/25/2025
Certification Date: 07/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5357 SPOKANE ST
DETROIT MI
48204-5026
US

IV. Provider business mailing address

2870 E GRAND BLVD STE 6685
DETROIT MI
48202-3129
US

V. Phone/Fax

Practice location:
  • Phone: 248-900-6038
  • Fax:
Mailing address:
  • Phone: 248-900-6038
  • 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 TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. SHONTIA A ANDERSON
Title or Position: CAREGIVER PROVIDER
Credential:
Phone: 248-798-3970