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General NPI Number Information
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NPI Number | 1710851415
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Entity Type | Organization
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Legal Business Name | TRAOSHI
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Dates
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Enumeration Date | 10/03/2025
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Last Update Date | 10/03/2025
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Provider Practice Location Address
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Address Line | 7738 WYKES ST
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City | DETROIT
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State | MI
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Zip | 48210-1026
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Country | US
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Telephone | 248-469-5570
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Fax |
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Provider Business Mailing Address
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Address Line | 20049 EVERGREEN MEADOWS RD
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City | SOUTHFIELD
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State | MI
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Zip | 48076-4214
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Country | US
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Telephone | 248-469-5570
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE OFFICER
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Name | TRACEY TATE
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Credential |
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Telephone | 248-469-5570
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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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 | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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