Healthcare Provider Details

I. General information

NPI: 1528986189
Provider Name (Legal Business Name): DARA'S OWN HOMECARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8224 CARLIN ST
DETROIT MI
48228-2735
US

IV. Provider business mailing address

8224 CARLIN ST
DETROIT MI
48228-2735
US

V. Phone/Fax

Practice location:
  • Phone: 313-759-6167
  • Fax: 313-759-6167
Mailing address:
  • Phone: 313-759-6167
  • Fax: 313-759-6167

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State

VIII. Authorized Official

Name: FIDELIS MOMODU
Title or Position: OWNER
Credential:
Phone: 313-759-6167