Healthcare Provider Details

I. General information

NPI: 1750209086
Provider Name (Legal Business Name): HIESPLACE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23151 COLUMBUS AVE
WARREN MI
48089-4434
US

IV. Provider business mailing address

23151 COLUMBUS AVE
WARREN MI
48089-4434
US

V. Phone/Fax

Practice location:
  • Phone: 586-335-0635
  • 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

VIII. Authorized Official

Name: KYIYA HINES
Title or Position: CAREGIVER/OWNER
Credential:
Phone: 586-335-0635