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General NPI Number Information
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NPI Number | 1790475093
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Entity Type | Organization
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Legal Business Name | LIFE CHORES SERVICES LIMITED LIABILITY COMPANY
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Dates
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Enumeration Date | 05/10/2023
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Last Update Date | 05/10/2023
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Provider Practice Location Address
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Address Line | 4678 MERRICK ST
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City | DEARBORN HEIGHTS
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State | MI
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Zip | 48125-2860
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Country | US
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Telephone | 313-925-6535
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Fax |
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Provider Business Mailing Address
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Address Line | 7275 MICHAEL ST
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City | TAYLOR
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State | MI
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Zip | 48180-1521
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Country | US
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Telephone | 131-392-5653
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MS. LANETRIA ANN GIBSON
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Credential |
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Telephone | 131-392-5653
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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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