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General NPI Number Information
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NPI Number | 1407250699
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Entity Type | Organization
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Legal Business Name | REDCROSS AFC HOME
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Dates
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Enumeration Date | 10/16/2014
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Last Update Date | 10/16/2014
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Provider Practice Location Address
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Address Line | 17036 E 9 MILE RD
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City | EASTPOINTE
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State | MI
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Zip | 48021-2451
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Country | US
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Telephone | 586-491-0989
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Fax |
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Provider Business Mailing Address
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Address Line | 17036 NINE MILE
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City | EASTPOINTE
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State | MI
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Zip | 48021
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Country | US
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Telephone | 586-491-0989
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DANA HALE
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Credential |
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Telephone | 586-491-0989
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State |
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