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General NPI Number Information
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NPI Number | 1790100766
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Entity Type | Organization
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Legal Business Name | UNIVERSITY HOMECARE
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Dates
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Enumeration Date | 02/27/2014
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Last Update Date | 02/27/2014
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Provider Practice Location Address
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Address Line | 11619 MEADOWS CIR
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City | BELLEVILLE
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State | MI
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Zip | 48111-3182
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Country | US
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Telephone | 734-716-4894
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Fax |
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Provider Business Mailing Address
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Address Line | 11619 MEADOWS CIR
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City | BELLEVILLE
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State | MI
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Zip | 48111-3182
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Country | US
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Telephone | 734-716-4894
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Fax |
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Authorized Official
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Title or Position | LICENSED PRACTICAL NURSE
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Name | GLORIA JEAN ALLEN
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Credential | LPN
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Telephone | 734-431-1246
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3140N1450X
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Taxonomy Name | Pediatric Skilled Nursing Facility
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License Number | 4703084955
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License Number State | MI
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