Healthcare Provider Details

I. General information

NPI: 1396503330
Provider Name (Legal Business Name): CHERISH LIFESTYLES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2024
Last Update Date: 03/12/2024
Certification Date: 03/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4625 BROWN RD
PARMA MI
49269-9680
US

IV. Provider business mailing address

4625 BROWN RD
PARMA MI
49269-9680
US

V. Phone/Fax

Practice location:
  • Phone: 845-843-0409
  • Fax:
Mailing address:
  • Phone: 845-843-0409
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: SHAWNDASHA HALL
Title or Position: OWNER/AUTHORIZED OFFICIAL
Credential:
Phone: 845-843-0409