Healthcare Provider Details

I. General information

NPI: 1033818380
Provider Name (Legal Business Name): ABILITY INTEGRATED CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2023
Last Update Date: 02/27/2023
Certification Date: 02/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5079 HARDWOODS DR
WEST BLOOMFIELD MI
48323-2733
US

IV. Provider business mailing address

5079 HARDWOODS DR
WEST BLOOMFIELD MI
48323-2733
US

V. Phone/Fax

Practice location:
  • Phone: 313-598-3631
  • Fax:
Mailing address:
  • Phone: 313-598-3631
  • 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 Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number State

VIII. Authorized Official

Name: MR. ROBERT MAGEE
Title or Position: PROVIDER
Credential: KRYSTAL MAGEE
Phone: 313-598-3631