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General NPI Number Information
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NPI Number | 1629009873
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Entity Type | Organization
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Legal Business Name | GREATER OAKLAND VISITING NURSE ASSOCIATION, INC.
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 06/09/2010
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Provider Practice Location Address
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Address Line | 959 W HURON ST
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City | WATERFORD
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State | MI
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Zip | 48328-3727
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Country | US
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Telephone | 248-683-1770
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Fax | 248-683-1774
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Provider Business Mailing Address
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Address Line | 959 W HURON ST
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City | WATERFORD
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State | MI
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Zip | 48328-3727
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Country | US
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Telephone | 248-683-1770
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Fax | 248-683-1774
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MRS. DONNA M FISHMAN
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Credential | M.S.N., M.S.B.A.
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Telephone | 248-683-1770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number | 237013
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 237013
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License Number State | MI
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