Healthcare Provider Details

I. General information

NPI: 1699136861
Provider Name (Legal Business Name): STANDARD OF EXCELLENCE LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2016
Last Update Date: 03/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38801 STEEPLE CHASE APT 28105
FARMINGTON HILLS MI
48331-4943
US

IV. Provider business mailing address

38801 STEEPLE CHASE APT 28105
FARMINGTON HILLS MI
48331-4943
US

V. Phone/Fax

Practice location:
  • Phone: 248-210-8480
  • Fax: 877-405-6659
Mailing address:
  • Phone: 248-210-8480
  • Fax: 877-405-6659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: GHAYDAA HANNA
Title or Position: ADMINISTRATOR
Credential:
Phone: 248-210-8480