Healthcare Provider Details

I. General information

NPI: 1922929462
Provider Name (Legal Business Name): KIMMIESLOVEANDCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29122 LANCASTER DR APT 205
SOUTHFIELD MI
48034-1437
US

IV. Provider business mailing address

43000 W 9 MILE RD STE 301
NOVI MI
48375-4129
US

V. Phone/Fax

Practice location:
  • Phone: 313-595-3890
  • Fax:
Mailing address:
  • Phone: 313-595-3890
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY ADELISHA JEFFRIES
Title or Position: WORKER
Credential:
Phone: 313-595-3890