Healthcare Provider Details

I. General information

NPI: 1447740931
Provider Name (Legal Business Name): BRIGHTSTAR CARE OF TROY/ROYAL OAK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2018
Last Update Date: 05/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 STEPHENSON HWY STE 480
TROY MI
48083-1109
US

IV. Provider business mailing address

550 STEPHENSON HWY STE 480
TROY MI
48083-1109
US

V. Phone/Fax

Practice location:
  • Phone: 734-363-7187
  • Fax:
Mailing address:
  • Phone:
  • 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 Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: JINAN ABBAS
Title or Position: OWNER
Credential:
Phone: 734-363-7187