Healthcare Provider Details

I. General information

NPI: 1184539173
Provider Name (Legal Business Name): CONCRETE ROSE HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2026
Last Update Date: 08/15/2026
Certification Date: 08/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43050 BURLINGTON DR
STERLING HEIGHTS MI
48313-1976
US

IV. Provider business mailing address

43050 BURLINGTON DR
STERLING HEIGHTS MI
48313-1976
US

V. Phone/Fax

Practice location:
  • Phone: 586-864-0545
  • Fax:
Mailing address:
  • Phone: 586-864-0545
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: DURINA DAPHINE ALLEN
Title or Position: OWNER
Credential:
Phone: 313-623-9272