Healthcare Provider Details

I. General information

NPI: 1295217115
Provider Name (Legal Business Name): MY ADVOCATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2018
Last Update Date: 09/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25901 W 10 MILE RD STE 222
SOUTHFIELD MI
48033-2857
US

IV. Provider business mailing address

25901 W 10 MILE RD STE 222
SOUTHFIELD MI
48033-2857
US

V. Phone/Fax

Practice location:
  • Phone: 248-730-3427
  • Fax:
Mailing address:
  • Phone: 248-730-3427
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MISS KATRENA A EDMONDSON
Title or Position: OPERTOR
Credential: LPN
Phone: 248-730-3427