Healthcare Provider Details

I. General information

NPI: 1669377701
Provider Name (Legal Business Name): EXODUS CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2785 E 14 MILE RD
STERLING HEIGHTS MI
48310-5962
US

IV. Provider business mailing address

2785 E 14 MILE RD
STERLING HEIGHTS MI
48310-5962
US

V. Phone/Fax

Practice location:
  • Phone: 586-301-2002
  • Fax: 586-404-9877
Mailing address:
  • Phone: 586-301-2002
  • Fax: 586-404-9877

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MARTIN FARIDA
Title or Position: OWNER
Credential:
Phone: 586-301-2002