Healthcare Provider Details

I. General information

NPI: 1013843457
Provider Name (Legal Business Name): 1ST TEAM HOMECARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16250 NORTHLAND DR STE 227
SOUTHFIELD MI
48075-5227
US

IV. Provider business mailing address

16250 NORTHLAND DR STE 227
SOUTHFIELD MI
48075-5227
US

V. Phone/Fax

Practice location:
  • Phone: 248-291-7605
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JESSIE RUCKES
Title or Position: PRESIDENT
Credential:
Phone: 313-414-9493