Healthcare Provider Details

I. General information

NPI: 1427830785
Provider Name (Legal Business Name): NERO ENTERPRISES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2023
Last Update Date: 11/14/2023
Certification Date: 11/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23079 REIN AVE
EASTPOINTE MI
48021-1739
US

IV. Provider business mailing address

23079 REIN AVE
EASTPOINTE MI
48021-1739
US

V. Phone/Fax

Practice location:
  • Phone: 347-480-2110
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: ANNETH EVWARAYE
Title or Position: CEO
Credential:
Phone: 313-335-7997