=====================================================
General NPI Number Information
=====================================================
NPI Number | 1285516088
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THE PATIENT PARTNER HHA LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/23/2025
-----------------------------------------------------
Last Update Date | 07/28/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5580 OREGON ST
-----------------------------------------------------
City | DETROIT
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48204-3610
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 313-626-0013
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5580 OREGON ST
-----------------------------------------------------
City | DETROIT
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48204-3610
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 313-626-0013
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | ANDREA WILLIAMS
-----------------------------------------------------
Credential | LPN
-----------------------------------------------------
Telephone | 614-800-6544
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 164W00000X
-----------------------------------------------------
Taxonomy Name | Licensed Practical Nurse
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------