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General NPI Number Information
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NPI Number | 1598647059
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Entity Type | Organization
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Legal Business Name | M&A ES LLCSQUARE NON MEDICAL HEALTH SERVIC
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Dates
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Enumeration Date | 07/24/2025
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Last Update Date | 07/24/2025
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Provider Practice Location Address
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Address Line | 20436 NORTHLAWN ST
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City | DETROIT
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State | MI
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Zip | 48221-1156
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Country | US
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Telephone | 313-402-6348
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Fax |
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Provider Business Mailing Address
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Address Line | 20436 NORTHLAWN ST
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City | DETROIT
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State | MI
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Zip | 48221-1156
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Country | US
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Telephone | 313-402-6348
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Fax |
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Authorized Official
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Title or Position | REGISTERES NURSE/EMPLOYEE
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Name | AKA NKEMATABONG
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Credential | REGISTERED NURSE
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Telephone | 313-402-6348
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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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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 | 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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