Healthcare Provider Details

I. General information

NPI: 1710074968
Provider Name (Legal Business Name): EPOCH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6319 GLASTONBURY ST
WESTLAND MI
48185-2837
US

IV. Provider business mailing address

6319 GLASTONBURY ST
WESTLAND MI
48185-2837
US

V. Phone/Fax

Practice location:
  • Phone: 734-261-8397
  • Fax: 734-422-2499
Mailing address:
  • Phone: 734-261-8397
  • Fax: 734-422-2499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number StateMI

VIII. Authorized Official

Name: MR. JAMES PALMER III
Title or Position: DIRECTOR
Credential:
Phone: 313-259-7656