Healthcare Provider Details

I. General information

NPI: 1720827785
Provider Name (Legal Business Name): MARYS HELPING HAND LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2024
Last Update Date: 06/04/2024
Certification Date: 06/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20542 LINDSAY ST
DETROIT MI
48235-2122
US

IV. Provider business mailing address

16200 WINSTON ST
DETROIT MI
48219-3610
US

V. Phone/Fax

Practice location:
  • Phone: 248-662-7567
  • Fax:
Mailing address:
  • Phone: 248-662-7567
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3104A0630X
TaxonomyAssisted Living Facility (Behavioral Disturbances)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3104A0625X
TaxonomyAssisted Living Facility (Mental Illness)
License Number
License Number State

VIII. Authorized Official

Name: AMINIKA STELL
Title or Position: OWNER
Credential:
Phone: 248-662-7567