Healthcare Provider Details

I. General information

NPI: 1790378271
Provider Name (Legal Business Name): SIMPLE CARE HOME HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2021
Last Update Date: 04/15/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14000 DIX TOLEDO RD UNIT 1029
SOUTHGATE MI
48195-9502
US

IV. Provider business mailing address

14000 DIX TOLEDO RD UNIT 1029
SOUTHGATE MI
48195-9502
US

V. Phone/Fax

Practice location:
  • Phone: 734-620-5813
  • Fax:
Mailing address:
  • Phone: 734-620-5813
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: VANESSA WATTS
Title or Position: CEO
Credential:
Phone: 313-717-2267