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General NPI Number Information
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NPI Number | 1336588524
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Entity Type | Organization
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Legal Business Name | LOVING MEMORIES HEALTH CARE LLC
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Dates
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Enumeration Date | 06/20/2013
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Last Update Date | 06/20/2013
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Provider Practice Location Address
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Address Line | 2280 LA BELLE ST
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City | DETROIT
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State | MI
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Zip | 48238-2944
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Country | US
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Telephone | 248-747-4074
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Fax | 248-747-4074
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Provider Business Mailing Address
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Address Line | 2280 LA BELLE ST
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City | DETROIT
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State | MI
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Zip | 48238-2944
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Country | US
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Telephone | 248-747-4074
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Fax | 248-747-4074
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | MS. GENEVA COLEMAN
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Credential | CNA
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Telephone | 248-924-2647
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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 |
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License Number State | MI
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