Healthcare Provider Details

I. General information

NPI: 1932933496
Provider Name (Legal Business Name): HCC CONNECTION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2024
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

189 COLORADO ST
HIGHLAND PARK MI
48203-3305
US

IV. Provider business mailing address

8200 E JEFFERSON AVE APT 201
DETROIT MI
48214-2663
US

V. Phone/Fax

Practice location:
  • Phone: 630-487-0813
  • Fax:
Mailing address:
  • Phone: 630-487-0813
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: JOVON C BURKES
Title or Position: CEO
Credential: LLPC
Phone: 630-487-0813