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General NPI Number Information
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NPI Number | 1669807384
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Entity Type | Organization
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Legal Business Name | UNIVERSAL PRIVATE DUTY NURSING SERVICES LLC
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Dates
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Enumeration Date | 09/12/2013
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Last Update Date | 09/12/2013
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Provider Practice Location Address
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Address Line | 20212 RYAN RD
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City | DETROIT
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State | MI
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Zip | 48234-1930
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Country | US
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Telephone | 313-424-3944
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Fax |
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Provider Business Mailing Address
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Address Line | 20212 RYAN RD
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City | DETROIT
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State | MI
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Zip | 48234-1930
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Country | US
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Telephone | 313-424-3944
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. KATHY A BRAXTON
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Credential | RN
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Telephone | 313-424-3944
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number |
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 253J00000X
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Taxonomy Name | Foster Care Agency
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License Number |
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License Number State | MI
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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 | MI
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