Healthcare Provider Details
I. General information
NPI: 1437048402
Provider Name (Legal Business Name): JENNIFER HOUGHTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/02/2025
Last Update Date: 07/02/2025
Certification Date: 07/02/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
675 COOPER ST
MONROE MI
48161-1676
US
IV. Provider business mailing address
13709 YORK BLVD
GARFIELD HEIGHTS OH
44125-4058
US
V. Phone/Fax
- Phone: 734-331-0222
- Fax: 734-331-0222
- Phone: 734-331-0222
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 172A00000X |
| Taxonomy | Driver |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | 602998900325 |
| License Number State | OH |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 282J00000X |
| Taxonomy | Religious Nonmedical Health Care Institution |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332U00000X |
| Taxonomy | Home Delivered Meals |
| License Number | RP953528 |
| License Number State | OH |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251J00000X |
| Taxonomy | Nursing Care Agency |
| License Number | 602998900325 |
| License Number State | OH |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | 602998900325 |
| License Number State | OH |
| # 7 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 343900000X |
| Taxonomy | Non-emergency Medical Transport (VAN) |
| License Number | RP953528 |
| License Number State | OH |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 342000000X |
| Taxonomy | Transportation Network Company |
| License Number | RP953528 |
| License Number State | OH |
| # 9 | |
| Primary Taxonomy | N |
| Taxonomy Code | 347B00000X |
| Taxonomy | Bus |
| License Number | RP953528 |
| License Number State | OH |
| # 10 | |
| Primary Taxonomy | N |
| Taxonomy Code | 347C00000X |
| Taxonomy | Private Vehicle |
| License Number | RP953528 |
| License Number State | OH |
| # 11 | |
| Primary Taxonomy | N |
| Taxonomy Code | 376K00000X |
| Taxonomy | Nurse's Aide |
| License Number | 602998900325 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: