Healthcare Provider Details

I. General information

NPI: 1497552269
Provider Name (Legal Business Name): VETTED LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2025
Last Update Date: 09/02/2025
Certification Date: 09/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2125 BUTTERFIELD DR STE 299
TROY MI
48084-3441
US

IV. Provider business mailing address

2125 BUTTERFIELD DR STE 299
TROY MI
48084-3441
US

V. Phone/Fax

Practice location:
  • Phone: 248-794-9292
  • Fax: 248-528-2646
Mailing address:
  • Phone: 248-794-9292
  • Fax: 248-528-2646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State

VIII. Authorized Official

Name: MR. EVAN MARK SHELLINE
Title or Position: PRESIDENT
Credential:
Phone: 248-794-9292