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General NPI Number Information
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NPI Number | 1154823417
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Entity Type | Organization
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Legal Business Name | HIGHLIFE HOMECARE INC
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Dates
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Enumeration Date | 03/02/2018
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Last Update Date | 03/02/2018
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Provider Practice Location Address
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Address Line | 38910 MINTON AVE
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City | LIVONIA
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State | MI
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Zip | 48150-3322
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Country | US
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Telephone | 248-890-8883
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Fax | 888-345-0261
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Provider Business Mailing Address
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Address Line | 38910 MINTON AVE
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City | LIVONIA
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State | MI
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Zip | 48150-3322
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Country | US
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Telephone | 248-890-8883
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Fax | 888-345-0261
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Authorized Official
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Title or Position | CO-INCORPORATOR / CO-OWNER
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Name | KENNETH GRANDON
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Credential |
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Telephone | 248-890-8883
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State | MI
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