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General NPI Number Information
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NPI Number | 1083313456
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Entity Type | Organization
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Legal Business Name | HEAL DETROIT N.O.W
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Dates
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Enumeration Date | 02/24/2023
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Last Update Date | 02/24/2023
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Provider Practice Location Address
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Address Line | 25524 LAWN ST APT B110
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City | ROSEVILLE
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State | MI
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Zip | 48066-3883
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Country | US
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Telephone | 248-835-3663
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Fax |
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Provider Business Mailing Address
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Address Line | 13935 COYLE ST
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City | DETROIT
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State | MI
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Zip | 48227-2534
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Country | US
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Telephone | 248-445-0297
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LAKEISHA MONEIK HARRIS
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Credential |
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Telephone | 248-445-0297
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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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