Healthcare Provider Details

I. General information

NPI: 1962649475
Provider Name (Legal Business Name): BEDSIDE ASSISTANT CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2009
Last Update Date: 01/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22992 PARK PLACE DR
SOUTHFIELD MI
48033-2661
US

IV. Provider business mailing address

22992 PARK PLACE DR
SOUTHFIELD MI
48033-2661
US

V. Phone/Fax

Practice location:
  • Phone: 248-773-6338
  • Fax:
Mailing address:
  • Phone: 248-773-6338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number230013837961007
License Number StateMI

VIII. Authorized Official

Name: MS. WHITNEY B. LINDSAY-JONES
Title or Position: OWNER AND PRESIDENT
Credential: CNA
Phone: 248-773-6338