Healthcare Provider Details

I. General information

NPI: 1437079514
Provider Name (Legal Business Name): PASSIONS HEARTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13543 POPLAR ST
SOUTHGATE MI
48195-2449
US

IV. Provider business mailing address

13543 POPLAR ST
SOUTHGATE MI
48195-2449
US

V. Phone/Fax

Practice location:
  • Phone: 734-899-7253
  • Fax:
Mailing address:
  • Phone: 734-899-7253
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. AYONNA WILSON
Title or Position: OWNER
Credential:
Phone: 734-899-7253