Healthcare Provider Details

I. General information

NPI: 1710808928
Provider Name (Legal Business Name): NAOMI HOME INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7022 SARGENT ST
ROMULUS MI
48174-1633
US

IV. Provider business mailing address

7022 SARGENT ST
ROMULUS MI
48174-1633
US

V. Phone/Fax

Practice location:
  • Phone: 734-331-9491
  • Fax: 734-331-4032
Mailing address:
  • Phone: 734-331-9491
  • Fax: 734-331-4032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: VIOLET R MUSTARI
Title or Position: LICENSEE/MANAGER
Credential: ADMINISTRATOR
Phone: 734-360-1154