=====================================================
General NPI Number Information
=====================================================
NPI Number | 1205749777
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALW CARE & WELLNESS LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/25/2026
-----------------------------------------------------
Last Update Date | 09/25/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 20028 LINDSAY ST
-----------------------------------------------------
City | DETROIT
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48235-2203
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 313-656-7553
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 20028 LINDSAY ST
-----------------------------------------------------
City | DETROIT
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48235-2203
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 313-656-7553
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/FOUNDER
-----------------------------------------------------
Name | ANNETTE LAVERNE MITCHELL
-----------------------------------------------------
Credential | CERTIFIED NURSE ASSI
-----------------------------------------------------
Telephone | 313-656-7553
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3747P1801X
-----------------------------------------------------
Taxonomy Name | Personal Care Attendant
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------