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General NPI Number Information
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NPI Number | 1669383220
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Entity Type | Organization
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Legal Business Name | LIFE RECOVERY LLC
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Dates
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Enumeration Date | 09/14/2026
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Last Update Date | 09/14/2026
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Provider Practice Location Address
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Address Line | 3964 RAVENSFIELD DR
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City | CANTON
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State | MI
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Zip | 48188-7925
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Country | US
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Telephone | 734-351-2926
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Fax | 734-340-2854
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Provider Business Mailing Address
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Address Line | 46036 MICHIGAN AVE # 141
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City | CANTON
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State | MI
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Zip | 48188-2304
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Country | US
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Telephone | 734-351-2926
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Fax | 734-340-2854
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Authorized Official
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Title or Position | OWNER
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Name | MICHELE ELAINE FAULKCON
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Credential |
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Telephone | 734-351-2926
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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