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General NPI Number Information
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NPI Number | 1699620773
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Entity Type | Organization
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Legal Business Name | VINCULUM CARE FOUNDATION
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Dates
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Enumeration Date | 03/03/2026
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Last Update Date | 03/03/2026
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Provider Practice Location Address
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Address Line | 1530 PINE GROVE AVE
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City | PORT HURON
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State | MI
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Zip | 48060-3370
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Country | US
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Telephone | 810-357-8792
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Fax | 810-512-7725
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Provider Business Mailing Address
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Address Line | 1530 PINE GROVE AVE
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City | PORT HURON
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State | MI
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Zip | 48060-3370
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Country | US
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Telephone | 810-357-8792
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Fax | 810-512-7725
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Authorized Official
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Title or Position | CEO
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Name | ELIA EJAZ HUSSAIN
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Credential |
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Telephone | 810-357-8792
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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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 | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #5
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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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Taxonomy #6
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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