Healthcare Provider Details

I. General information

NPI: 1144454281
Provider Name (Legal Business Name): RENAISSANCE HOME HEALTHCARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2009
Last Update Date: 05/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27241 NANTUCKET DR SUITE 101
SOUTHFIELD MI
48076-4804
US

IV. Provider business mailing address

27241 NANTUCKET DR SUITE 101
SOUTHFIELD MI
48076-4804
US

V. Phone/Fax

Practice location:
  • Phone: 313-330-0393
  • Fax:
Mailing address:
  • Phone: 313-330-0393
  • 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: DR. EGERTON OKOYAMA ABULU
Title or Position: PRESIDENT
Credential: PH.D, MBA, M.SC,
Phone: 313-330-1194