Healthcare Provider Details

I. General information

NPI: 1851774673
Provider Name (Legal Business Name): WILLIAMS HOME HELP AID
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2015
Last Update Date: 06/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18685 HOOVER ST
DETROIT MI
48205-2668
US

IV. Provider business mailing address

18685 HOOVER ST
DETROIT MI
48205-2668
US

V. Phone/Fax

Practice location:
  • Phone: 313-394-9860
  • Fax:
Mailing address:
  • Phone: 313-394-9860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License NumberW452671799376
License Number StateMI

VIII. Authorized Official

Name: MS. OWINA WILLIAMS
Title or Position: HOME HELP AID
Credential:
Phone: 313-394-9860