Healthcare Provider Details

I. General information

NPI: 1760396196
Provider Name (Legal Business Name): JOLITA BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26026 TELEGRAPH RD STE 200-1017
SOUTHFIELD MI
48033-2560
US

IV. Provider business mailing address

20447 STOTTER ST
DETROIT MI
48234-3109
US

V. Phone/Fax

Practice location:
  • Phone: 248-329-4752
  • Fax:
Mailing address:
  • Phone: 623-432-6225
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: