Healthcare Provider Details

I. General information

NPI: 1508201724
Provider Name (Legal Business Name): COMPLETE CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2013
Last Update Date: 05/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

461 S MAIN ST
PLYMOUTH MI
48170-1708
US

IV. Provider business mailing address

461 S MAIN ST
PLYMOUTH MI
48170-1708
US

V. Phone/Fax

Practice location:
  • Phone: 248-561-4543
  • Fax: 734-468-0138
Mailing address:
  • Phone: 248-561-4543
  • Fax: 734-468-0138

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberE18137
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License NumberE18137
License Number StateMI

VIII. Authorized Official

Name: SANJAY SHARMA
Title or Position: PRESIDENT & CEO
Credential:
Phone: 248-561-4543