Healthcare Provider Details

I. General information

NPI: 1316231657
Provider Name (Legal Business Name): HYGIENE ON WHEELS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2011
Last Update Date: 03/28/2023
Certification Date: 04/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28408 BRENTWOOD ST
SOUTHFIELD MI
48076-3004
US

IV. Provider business mailing address

28408 BRENTWOOD ST
SOUTHFIELD MI
48076-3004
US

V. Phone/Fax

Practice location:
  • Phone: 313-231-5871
  • Fax:
Mailing address:
  • Phone: 313-231-5871
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. DEANNA C ALEXANDER
Title or Position: OWNER/OPERATOR
Credential: RDH
Phone: 313-231-5871