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General NPI Number Information
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NPI Number | 1538956461
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Entity Type | Organization
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Legal Business Name | WAYNE COUNTY HOME CARE LLC
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Dates
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Enumeration Date | 04/23/2025
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Last Update Date | 04/23/2025
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Provider Practice Location Address
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Address Line | 1707 SHORE CLUB DR
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City | SAINT CLAIR SHORES
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State | MI
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Zip | 48080-1567
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Country | US
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Telephone | 248-508-2004
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Fax | 800-925-7765
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Provider Business Mailing Address
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Address Line | 1707 SHORE CLUB DR
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City | SAINT CLAIR SHORES
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State | MI
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Zip | 48080-1567
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Country | US
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Telephone | 248-508-2004
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Fax | 800-925-7765
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Authorized Official
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Title or Position | OWNER
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Name | SANDRA GIBSON
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Credential |
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Telephone | 124-850-8200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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