Healthcare Provider Details

I. General information

NPI: 1801716469
Provider Name (Legal Business Name): WILL OF SON HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1220 CHIPPEWA ST
FLINT MI
48503-1532
US

IV. Provider business mailing address

1220 CHIPPEWA ST
FLINT MI
48503-1532
US

V. Phone/Fax

Practice location:
  • Phone: 810-936-3925
  • Fax:
Mailing address:
  • Phone: 810-936-3925
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: DEMMETRIA WILSON
Title or Position: OWNER
Credential: CNA
Phone: 810-936-3925