Healthcare Provider Details

I. General information

NPI: 1578444147
Provider Name (Legal Business Name): STAY HOME WITH US
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2025
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18633 MACKAY ST
DETROIT MI
48234-1484
US

IV. Provider business mailing address

18633 MACKAY ST
DETROIT MI
48234-1484
US

V. Phone/Fax

Practice location:
  • Phone: 313-395-4923
  • Fax:
Mailing address:
  • Phone: 313-395-4923
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311Z00000X
TaxonomyCustodial Care Facility
License Number
License Number State

VIII. Authorized Official

Name: MRS. JIMAVIS ARNOLD
Title or Position: ADMINISTRATOR
Credential: BSN,RN
Phone: 313-395-4923