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General NPI Number Information
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NPI Number | 1164822128
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Entity Type | Organization
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Legal Business Name | ABBOTT HOME CARE SERVICES LLC
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Dates
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Enumeration Date | 08/27/2014
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Last Update Date | 08/27/2014
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Provider Practice Location Address
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Address Line | 18230 W MCNICHOLS RD
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City | DETROIT
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State | MI
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Zip | 48219-4163
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Country | US
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Telephone | 313-535-4833
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Fax | 313-535-5393
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Provider Business Mailing Address
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Address Line | 18230 W MCNICHOLS RD
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City | DETROIT
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State | MI
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Zip | 48219-4163
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Country | US
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Telephone | 313-535-4833
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Fax | 313-535-5393
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | GLORIA N OHAKPO
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Credential | RN, BSN, MSN
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Telephone | 313-535-4833
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 4704187806
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License Number State | MI
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