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General NPI Number Information
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NPI Number | 1104452143
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Entity Type | Organization
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Legal Business Name | OBIOMA CARE HOME HEALTH AGENCY
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Dates
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Enumeration Date | 03/22/2020
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Last Update Date | 03/22/2020
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Provider Practice Location Address
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Address Line | 26847 GRAND RIVER AVE STE 7
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City | REDFORD
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State | MI
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Zip | 48240-1544
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Country | US
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Telephone | 248-390-3632
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Fax |
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Provider Business Mailing Address
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Address Line | 26847 GRAND RIVER AVE STE 7
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City | REDFORD
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State | MI
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Zip | 48240-1544
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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 / ADMINISTRATOR
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Name | MR. ODINAKA OSCAR DURU
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Credential |
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Telephone | 248-390-3632
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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