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General NPI Number Information
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NPI Number | 1124731104
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Entity Type | Organization
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Legal Business Name | DIRECT 2 HOME CARE LLC
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Dates
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Enumeration Date | 01/04/2023
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Last Update Date | 01/04/2023
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Provider Practice Location Address
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Address Line | 17663 W 10 MILE RD
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City | SOUTHFIELD
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State | MI
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Zip | 48075-2756
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Country | US
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Telephone | 248-914-1681
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Fax |
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Provider Business Mailing Address
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Address Line | 17663 W 10 MILE RD
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City | SOUTHFIELD
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State | MI
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Zip | 48075-2756
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Country | US
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Telephone | 248-914-1681
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | BENJMAIN JOHN HOLLAWAY
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Credential |
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Telephone | 248-914-1681
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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