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General NPI Number Information
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NPI Number | 1780294850
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Entity Type | Organization
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Legal Business Name | BACO CARE SERVICES LLC
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Dates
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Enumeration Date | 08/04/2020
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Last Update Date | 10/22/2025
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Provider Practice Location Address
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Address Line | 26911 NORTHWESTERN HWY STE 530
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City | SOUTHFIELD
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State | MI
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Zip | 48033-4717
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Country | US
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Telephone | 947-522-0017
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Fax |
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Provider Business Mailing Address
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Address Line | 26911 NORTHWESTERN HWY STE 530
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City | SOUTHFIELD
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State | MI
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Zip | 48033-4717
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Country | US
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Telephone | 947-522-0017
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | WALTER LORANG
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Credential |
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Telephone | 947-522-0037
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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