Healthcare Provider Details

I. General information

NPI: 1346665940
Provider Name (Legal Business Name): TOTAL CARE PLUS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2014
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3899 24TH AVE SUITE 1
FORT GRATIOT MI
48059-4101
US

IV. Provider business mailing address

3899 24TH AVE SUITE 1
FORT GRATIOT MI
48059-4101
US

V. Phone/Fax

Practice location:
  • Phone: 810-990-8950
  • Fax: 810-990-8952
Mailing address:
  • Phone: 810-990-8950
  • Fax: 810-990-8952

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385HR2050X
TaxonomyRespite Care Camp
License Number
License Number State

VIII. Authorized Official

Name: LEEANN MICHELLE WHITE
Title or Position: VICE PRESIDENT
Credential:
Phone: 810-858-7963