Healthcare Provider Details

I. General information

NPI: 1700710209
Provider Name (Legal Business Name): INTERNATIONAL CUISINE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4130 TRUMBULL ST STE 4
DETROIT MI
48208-3600
US

IV. Provider business mailing address

4130 TRUMBULL ST STE 4
DETROIT MI
48208-3600
US

V. Phone/Fax

Practice location:
  • Phone: 248-679-6686
  • Fax: 248-679-6686
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number State

VIII. Authorized Official

Name: DARRELL GOODMAN
Title or Position: OWNER/EXECUTIVE CHEF
Credential:
Phone: 248-679-6686