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General NPI Number Information
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NPI Number | 1558557603
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Entity Type | Organization
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Legal Business Name | PURE HEARTS HOMECARE SERVICES
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Dates
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Enumeration Date | 09/22/2007
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Last Update Date | 09/22/2007
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Provider Practice Location Address
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Address Line | 2958 TOWNSEND ST
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City | DETROIT
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State | MI
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Zip | 48214-1731
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Country | US
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Telephone | 313-736-6379
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 141025
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City | DETROIT
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State | MI
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Zip | 48214-5025
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Country | US
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Telephone | 313-736-6379
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Fax |
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Authorized Official
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Title or Position | NURSING ASSISTANT
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Name | YOLONDA MONIQUE MATTHEWS
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Credential | CNA
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Telephone | 313-736-6379
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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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