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General NPI Number Information
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NPI Number | 1578363776
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Entity Type | Organization
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Legal Business Name | LUXURY MANAGEMENT GROUP LLC
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Dates
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Enumeration Date | 03/17/2025
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Last Update Date | 03/17/2025
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Provider Practice Location Address
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Address Line | 3200 GREENFIELD RD
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City | DEARBORN
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State | MI
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Zip | 48120-1802
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Country | US
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Telephone | 313-409-0846
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Fax |
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Provider Business Mailing Address
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Address Line | 3706 HERITAGE PKWY
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City | DEARBORN
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State | MI
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Zip | 48124-3152
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TIARA BARDWELL
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Credential |
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Telephone | 313-409-0846
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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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