Healthcare Provider Details

I. General information

NPI: 1750903886
Provider Name (Legal Business Name): TANYI CHARLES AGBOR-BAIYEE MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2020
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7900 SHIRE LN
YPSILANTI MI
48197-1860
US

IV. Provider business mailing address

7900 SHIRE LN
YPSILANTI MI
48197-1860
US

V. Phone/Fax

Practice location:
  • Phone: 734-635-5688
  • Fax:
Mailing address:
  • Phone: 734-635-5688
  • Fax: 734-635-5688

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number StateMI
# 4
Primary TaxonomyY
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: