Healthcare Provider Details

I. General information

NPI: 1194323154
Provider Name (Legal Business Name): C-ASSIST
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2020
Last Update Date: 09/04/2022
Certification Date: 09/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30260 CHERRY HILL RD
GARDEN CITY MI
48135
US

IV. Provider business mailing address

30260 CHERRY HILL RD
GARDEN CITY MI
48135-2676
US

V. Phone/Fax

Practice location:
  • Phone: 313-670-9943
  • Fax: 313-769-5025
Mailing address:
  • Phone: 313-670-9943
  • Fax: 313-769-5025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QP0905X
TaxonomyState or Local Public Health Clinic/Center
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. NANCY BERRY
Title or Position: C.E.O. & CO-FOUNDER
Credential:
Phone: 313-995-0246