Healthcare Provider Details

I. General information

NPI: 1528920741
Provider Name (Legal Business Name): REGINA'S HOME, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/25/2025
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

139 TAYLOR ST
DETROIT MI
48202-1712
US

IV. Provider business mailing address

139 TAYLOR ST
DETROIT MI
48202-1712
US

V. Phone/Fax

Practice location:
  • Phone: 313-268-5204
  • Fax: 313-861-0644
Mailing address:
  • Phone: 313-268-5204
  • Fax: 313-861-0644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. ELLEN LEWIS
Title or Position: PRESIDENT
Credential:
Phone: 313-268-5204