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General NPI Number Information
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NPI Number | 1366194144
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Entity Type | Individual
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Provider Name | CAROLINE COOK HOME CARE PROVIDER
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Gender | Female
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Dates
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Enumeration Date | 01/22/2022
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Last Update Date | 01/22/2022
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Provider Practice Location Address
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Address Line | 8700 CONTINENTAL AVE
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City | WARREN
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State | MI
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Zip | 48089-1790
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Country | US
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Telephone | 586-806-6966
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Fax | 586-283-0380
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Provider Business Mailing Address
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Address Line | PO BOX 613
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City | EASTPOINTE
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State | MI
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Zip | 48021-0613
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Country | US
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Telephone | 313-208-3020
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Fax | 586-586-2830
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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