Healthcare Provider Details

I. General information

NPI: 1225715675
Provider Name (Legal Business Name): CARE WITH GREATNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2023
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19194 MELROSE AVE
SOUTHFIELD MI
48075-5753
US

IV. Provider business mailing address

19194 MELROSE AVE
SOUTHFIELD MI
48075-5753
US

V. Phone/Fax

Practice location:
  • Phone: 248-254-2561
  • Fax: 248-289-4476
Mailing address:
  • Phone: 248-254-2561
  • Fax: 248-289-4476

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: MS. KEISHAWNA SEMEKA GAVIN
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 248-283-3707