Healthcare Provider Details

I. General information

NPI: 1649631177
Provider Name (Legal Business Name): TRANSITIONAL CARE MANAGEMENT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2016
Last Update Date: 05/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28175 HAGGERTY RD
NOVI MI
48377-2903
US

IV. Provider business mailing address

28175 HAGGERTY RD
NOVI MI
48377-2903
US

V. Phone/Fax

Practice location:
  • Phone: 248-961-4715
  • Fax: 248-694-2071
Mailing address:
  • Phone: 248-961-4715
  • Fax: 248-694-2071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: HEATHER SMITH
Title or Position: CEO
Credential: RN
Phone: 248-961-4715