Healthcare Provider Details

I. General information

NPI: 1164349858
Provider Name (Legal Business Name): PARADISE CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22021 CHURCH ST
OAK PARK MI
48237-2641
US

IV. Provider business mailing address

22021 CHURCH ST
OAK PARK MI
48237-2641
US

V. Phone/Fax

Practice location:
  • Phone: 734-560-3067
  • Fax:
Mailing address:
  • Phone: 734-560-3067
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: NGAYI GAMNJE
Title or Position: ADMINISTRATOR
Credential:
Phone: 734-560-3067