Healthcare Provider Details

I. General information

NPI: 1962047969
Provider Name (Legal Business Name): EXQUISITE HELPERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2019
Last Update Date: 11/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30308 MOULIN AVE
WARREN MI
48088-6826
US

IV. Provider business mailing address

30308 MOULIN AVE
WARREN MI
48088-6826
US

V. Phone/Fax

Practice location:
  • Phone: 586-267-0303
  • Fax: 586-267-0332
Mailing address:
  • Phone: 586-267-0303
  • Fax: 586-267-0332

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: ALISHA S JACKSON
Title or Position: OWNER
Credential:
Phone: 313-215-2282