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General NPI Number Information
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NPI Number | 1447071824
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Entity Type | Organization
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Legal Business Name | DAVID HOME CARE LLC
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Dates
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Enumeration Date | 10/18/2024
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Last Update Date | 10/18/2024
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Provider Practice Location Address
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Address Line | 23900 OUTER DR STE 2
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City | MELVINDALE
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State | MI
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Zip | 48122-1646
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Country | US
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Telephone | 248-670-6909
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Fax |
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Provider Business Mailing Address
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Address Line | 23900 OUTER DR STE 2
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City | MELVINDALE
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State | MI
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Zip | 48122-1646
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Country | US
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Telephone | 248-670-6909
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BRIGGITTEE JACKSON
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Credential |
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Telephone | 248-670-6909
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 372500000X
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Taxonomy Name | Chore Provider
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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Taxonomy #5
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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 |
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