Healthcare Provider Details

I. General information

NPI: 1093523003
Provider Name (Legal Business Name): KARE WELL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/23/2024
Last Update Date: 12/23/2024
Certification Date: 12/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 ECORSE RD STE 11
YPSILANTI MI
48198-5743
US

IV. Provider business mailing address

PO BOX 24183
LANSING MI
48909-4183
US

V. Phone/Fax

Practice location:
  • Phone: 877-745-7452
  • Fax: 888-288-5304
Mailing address:
  • Phone: 877-745-7452
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name: KAREN GREENE REYNOLDS
Title or Position: PRINCIPLE, CEO
Credential: DHA, BCPA, CPC
Phone: 517-712-9787