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General NPI Number Information
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NPI Number | 1134258577
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Entity Type | Organization
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Legal Business Name | HYFS HERE FOR YOUR SERVICES
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Dates
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Enumeration Date | 03/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 15146 GRAYFIELD ST
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City | DETROIT
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State | MI
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Zip | 48223-1822
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Country | US
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Telephone | 313-720-2563
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Fax | 313-543-9328
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Provider Business Mailing Address
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Address Line | 15146 GRAYFIELD ST
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City | DETROIT
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State | MI
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Zip | 48223-1822
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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 | COORDINATOR
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Name | DAMIEN SANFORD
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Credential |
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Telephone | 313-720-2563
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number | S516765135111
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License Number State | MI
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