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General NPI Number Information
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NPI Number | 1669232732
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Entity Type | Organization
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Legal Business Name | NSUHODEIDEM OKON
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Dates
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Enumeration Date | 03/19/2024
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Last Update Date | 03/19/2024
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Provider Practice Location Address
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Address Line | 15545 OCONNOR AVE
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City | ALLEN PARK
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State | MI
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Zip | 48101-2717
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Country | US
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Telephone | 586-345-4641
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Fax |
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Provider Business Mailing Address
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Address Line | 15545 OCONNOR AVE
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City | ALLEN PARK
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State | MI
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Zip | 48101-2717
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Country | US
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Telephone | 586-345-4641
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NSUHODEIDEM OKON
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Credential |
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Telephone | 586-345-4641
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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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 | 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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