Healthcare Provider Details
I. General information
NPI: 1437420189
Provider Name (Legal Business Name): JZ CHATS HOME HEATH SERVICES OF MICHIGAN
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/25/2012
Last Update Date: 01/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
25800 NORTHWESTERN HWY STE 150
SOUTHFIELD MI
48075-8403
US
IV. Provider business mailing address
25800 NORTHWESTERN HWY STE 150
SOUTHFIELD MI
48075-8403
US
V. Phone/Fax
- Phone: 248-594-7722
- Fax:
- Phone: 248-594-7722
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 246Z00000X |
| Taxonomy | Other Specialist/Technologist |
| License Number | 3320150 |
| License Number State | MI |
VIII. Authorized Official
Name:
CHERYL
MCNEAL
Title or Position: CEO
Credential:
Phone: 248-594-7722