Healthcare Provider Details

I. General information

NPI: 1497659031
Provider Name (Legal Business Name): MILLSTONE HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25520 GARDNER ST
OAK PARK MI
48237-1328
US

IV. Provider business mailing address

5568 HACKBERRY CV
MEMPHIS TN
38120-2408
US

V. Phone/Fax

Practice location:
  • Phone: 845-310-6500
  • Fax: 901-749-8118
Mailing address:
  • Phone: 845-310-6500
  • Fax: 901-749-8118

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: SHARON NIMAN
Title or Position: MANAGING MEMBER
Credential:
Phone: 845-310-6500