Healthcare Provider Details

I. General information

NPI: 1629442488
Provider Name (Legal Business Name): ALL SECURE CARE HOMES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2015
Last Update Date: 11/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24333 SOUTHFIELD RD STE 109
SOUTHFIELD MI
48075-2848
US

IV. Provider business mailing address

24333 SOUTHFIELD RD STE 109
SOUTHFIELD MI
48075-2848
US

V. Phone/Fax

Practice location:
  • Phone: 248-525-3424
  • Fax:
Mailing address:
  • Phone: 248-525-3424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MISS EMELIN TERESA WILLIAMS-NELSON
Title or Position: OWNER/ ADMIN
Credential: RN
Phone: 248-525-3424