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General NPI Number Information
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NPI Number | 1467267310
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Entity Type | Organization
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Legal Business Name | GRACE AND RUTH'S HOUSE OF WELLNESS
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Dates
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Enumeration Date | 02/10/2025
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Last Update Date | 02/10/2025
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Provider Practice Location Address
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Address Line | 10886 PARDEE RD
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City | TAYLOR
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State | MI
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Zip | 48180-3554
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Country | US
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Telephone | 313-805-2060
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Fax |
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Provider Business Mailing Address
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Address Line | 10886 PARDEE RD
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City | TAYLOR
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State | MI
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Zip | 48180-3554
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Country | US
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Telephone | 313-805-2060
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Fax |
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Authorized Official
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Title or Position | LICENSE PRACTICAL NURSE
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Name | MS. ALEXIS TREADAWAY
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Credential | LPN
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Telephone | 313-805-2060
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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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