Healthcare Provider Details

I. General information

NPI: 1750648093
Provider Name (Legal Business Name): E AND S CARE L&C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2012
Last Update Date: 02/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 HIGHLAND ST
HIGHLAND PARK MI
48203
US

IV. Provider business mailing address

21 HIGHLAND ST
HIGHLAND PARK MI
48203
US

V. Phone/Fax

Practice location:
  • Phone: 313-208-1075
  • Fax:
Mailing address:
  • Phone: 313-208-1075
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: MS. EUGENIA RENEE DARNELL
Title or Position: CEO/OWNER ADMINISTRATOR
Credential:
Phone: 313-208-1075