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General NPI Number Information
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NPI Number | 1023248077
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Entity Type | Organization
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Legal Business Name | RENE'S HOME CARE NURSING LLC
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Dates
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Enumeration Date | 07/23/2009
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Last Update Date | 07/23/2009
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Provider Practice Location Address
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Address Line | 6848 ALLEN RD
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City | ALLEN PARK
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State | MI
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Zip | 48101-2008
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Country | US
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Telephone | 313-388-3500
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Fax | 313-381-4784
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Provider Business Mailing Address
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Address Line | 17939 RUTH ST
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City | MELVINDALE
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State | MI
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Zip | 48122-1524
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Country | US
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Telephone | 313-381-6724
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Fax | 313-381-4784
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Authorized Official
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Title or Position | OWNER/CEO
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Name | RENE J GONZALEZ
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Credential |
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Telephone | 313-381-6724
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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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