NPI Code Details Logo

NPI 1164350658

NPI 1164350658 : HEARTSTEAD HOME CARE LLC : CANTON, MI

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1164350658
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    HEARTSTEAD HOME CARE LLC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    05/13/2026
-----------------------------------------------------
    Last Update Date     |    05/13/2026
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    41021 OLD MICHIGAN AVE TRLR 221 
-----------------------------------------------------
    City                 |    CANTON
-----------------------------------------------------
    State                |    MI
-----------------------------------------------------
    Zip                  |    48188-2728
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    248-200-6168
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    41021 OLD MICHIGAN AVE TRLR 221 
-----------------------------------------------------
    City                 |    CANTON
-----------------------------------------------------
    State                |    MI
-----------------------------------------------------
    Zip                  |    48188-2728
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    OWNER
-----------------------------------------------------
    Name                 |     SHONTASSIA D WOODS 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    248-200-6168
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    374U00000X
-----------------------------------------------------
    Taxonomy Name        |    Home Health Aide
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.