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General NPI Number Information
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NPI Number | 1689366072
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Entity Type | Organization
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Legal Business Name | EMPRESS EMPIRE
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Dates
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Enumeration Date | 05/23/2023
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Last Update Date | 05/23/2023
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Provider Practice Location Address
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Address Line | 21117 DEXTER BLVD
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City | WARREN
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State | MI
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Zip | 48089-3405
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Country | US
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Telephone | 158-628-0743
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Fax |
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Provider Business Mailing Address
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Address Line | 21117 DEXTER BLVD
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City | WARREN
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State | MI
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Zip | 48089-3405
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Country | US
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Telephone | 158-628-0743
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | TARA SHERRELL HENRY
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Credential | HOME HEALTH ADENCY
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Telephone | 586-280-7436
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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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