Healthcare Provider Details

I. General information

NPI: 1225402506
Provider Name (Legal Business Name): FRIENDS WHO CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2015
Last Update Date: 11/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 GREENWOOD AVE LOWER LEVEL
JACKSON MI
49203
US

IV. Provider business mailing address

2766 WEST MILE ROAD STU 2
BERKLEY MI
48072
US

V. Phone/Fax

Practice location:
  • Phone: 517-787-5710
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number0000085140
License Number StateMI

VIII. Authorized Official

Name: MRS. NAOMI SANDERS
Title or Position: OFFICE MANGER
Credential:
Phone: 517-787-5710