Healthcare Provider Details

I. General information

NPI: 1821042250
Provider Name (Legal Business Name): SUMMIT HOME CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26370 GRAND RIVER AVE
REDFORD MI
48240-1463
US

IV. Provider business mailing address

26370 GRAND RIVER AVE
REDFORD MI
48240-1463
US

V. Phone/Fax

Practice location:
  • Phone: 313-533-1400
  • Fax: 313-533-1402
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number03639E
License Number StateMI

VIII. Authorized Official

Name: MS. KAJARI GAYEN
Title or Position: PRESIDENT
Credential:
Phone: 313-533-1400