Healthcare Provider Details

I. General information

NPI: 1134999451
Provider Name (Legal Business Name): D & D FAMILY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2024
Last Update Date: 01/08/2024
Certification Date: 01/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4542 PAGE AVE
MICHIGAN CENTER MI
49254-1040
US

IV. Provider business mailing address

4542 PAGE AVE
MICHIGAN CENTER MI
49254-1040
US

V. Phone/Fax

Practice location:
  • Phone: 517-764-1202
  • Fax: 517-782-0052
Mailing address:
  • Phone: 517-764-1202
  • Fax: 517-782-0052

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 Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: LILLIAN BERNICE DONNELLY
Title or Position: OWNER
Credential:
Phone: 517-764-1202