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General NPI Number Information
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NPI Number | 1104460971
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Entity Type | Organization
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Legal Business Name | LOVINGPRIVATECARE71 LLC
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Dates
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Enumeration Date | 11/04/2019
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Last Update Date | 01/07/2020
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Provider Practice Location Address
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Address Line | 24020 SUNNYPOINT DR
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City | SOUTHFIELD
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State | MI
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Zip | 48033-2907
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Country | US
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Telephone | 248-802-1619
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Fax | 248-200-7704
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Provider Business Mailing Address
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Address Line | 24020 SUNNYPOINT DR
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City | SOUTHFIELD
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State | MI
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Zip | 48033-2907
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Country | US
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Telephone | 248-802-1619
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Fax | 248-200-7704
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Authorized Official
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Title or Position | OWNER
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Name | MS. DANA ROGERS
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Credential |
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Telephone | 313-207-0056
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number |
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License Number State |
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