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General NPI Number Information
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NPI Number | 1396244679
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Entity Type | Organization
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Legal Business Name | CIRCLE OF FRIENDS CARE
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Dates
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Enumeration Date | 02/01/2018
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Last Update Date | 02/01/2018
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Provider Practice Location Address
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Address Line | 19621 HANNA ST
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City | DETROIT
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State | MI
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Zip | 48203-1367
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Country | US
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Telephone | 313-772-1661
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Fax | 313-731-0576
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Provider Business Mailing Address
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Address Line | 14412 GRATIOT AVE
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City | DETROIT
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State | MI
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Zip | 48205-2307
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Country | US
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Telephone | 313-261-2000
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Fax | 313-731-0576
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Authorized Official
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Title or Position | OWNER
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Name | MS. ENA GWENTAIL MCKEE
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Credential | CEO
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Telephone | 313-772-1661
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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 | 7157793
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License Number State | MI
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