Healthcare Provider Details

I. General information

NPI: 1255267480
Provider Name (Legal Business Name): THE IMPERIAL ELITE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1938 BURDETTE ST STE 3031
FERNDALE MI
48220-1982
US

IV. Provider business mailing address

1938 BURDETTE ST # 3031
FERNDALE MI
48220-1982
US

V. Phone/Fax

Practice location:
  • Phone: 517-512-4384
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: TIFFANY WIMBERLY
Title or Position: CEO
Credential:
Phone: 517-512-4384