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General NPI Number Information
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NPI Number | 1588347678
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Entity Type | Organization
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Legal Business Name | MADISON OAKS HOME CARE LLC
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Dates
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Enumeration Date | 08/07/2023
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Last Update Date | 08/07/2023
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Provider Practice Location Address
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Address Line | 16150 JAMES COUZENS FWY
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City | DETROIT
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State | MI
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Zip | 48221-2822
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Country | US
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Telephone | 313-626-0220
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Fax |
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Provider Business Mailing Address
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Address Line | 21601 CLOVERLAWN ST
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City | OAK PARK
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State | MI
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Zip | 48237-2630
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Country | US
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Telephone | 313-605-6080
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AKILIA WELLS-JACKSON
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Credential | RN
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Telephone | 313-605-6080
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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 | 251J00000X
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Taxonomy Name | Nursing Care 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 | 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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Taxonomy #4
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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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 | 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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