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General NPI Number Information
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NPI Number | 1013715036
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Entity Type | Organization
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Legal Business Name | SKP ENTERPRIES LLC
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Dates
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Enumeration Date | 03/05/2025
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Last Update Date | 03/13/2025
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Provider Practice Location Address
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Address Line | 16885 SNOWDEN ST
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City | DETROIT
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State | MI
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Zip | 48235-4230
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Country | US
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Telephone | 434-262-0052
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Fax |
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Provider Business Mailing Address
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Address Line | 16885 SNOWDEN ST
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City | DETROIT
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State | MI
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Zip | 48235-4230
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHAPRIE PEATROSS
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Credential |
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Telephone | 494-262-0052
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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