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General NPI Number Information
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NPI Number | 1033973292
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Entity Type | Organization
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Legal Business Name | RP PANACEA LLC
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Dates
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Enumeration Date | 02/08/2024
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Last Update Date | 02/08/2024
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Provider Practice Location Address
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Address Line | 1098 ANN ARBOR RD W STE 643
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City | PLYMOUTH
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State | MI
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Zip | 48170-2129
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Country | US
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Telephone | 313-595-2611
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Fax |
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Provider Business Mailing Address
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Address Line | 9392 PINEHURST ST
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City | DETROIT
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State | MI
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Zip | 48204-2658
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Country | US
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Telephone | 313-595-2611
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | IMAREE ROBINSON
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Credential |
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Telephone | 313-595-2611
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 320700000X
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Taxonomy Name | Physical Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 374T00000X
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Taxonomy Name | Religious Nonmedical Nursing Personnel
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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Taxonomy #8
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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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