Healthcare Provider Details

I. General information

NPI: 1639852056
Provider Name (Legal Business Name): NJOYSENIORSERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2023
Last Update Date: 08/11/2023
Certification Date: 08/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26620 BURG RD APT C219
WARREN MI
48089-1000
US

IV. Provider business mailing address

26620 BURG RD APT C219
WARREN MI
48089-1000
US

V. Phone/Fax

Practice location:
  • Phone: 586-883-8122
  • Fax:
Mailing address:
  • Phone: 586-883-8122
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number
License Number State

VIII. Authorized Official

Name: MS. CHARCIE BRAY-FRAZIER
Title or Position: OWNER
Credential: LPN
Phone: 313-815-5091