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General NPI Number Information
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NPI Number | 1821988742
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Entity Type | Organization
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Legal Business Name | RESTFUL RETREAT LLC
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Dates
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Enumeration Date | 07/03/2025
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Last Update Date | 07/03/2025
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Provider Practice Location Address
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Address Line | 19683 BELAND ST
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City | DETROIT
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State | MI
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Zip | 48234-3527
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Country | US
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Telephone | 313-659-8043
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Fax |
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Provider Business Mailing Address
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Address Line | 17835 LINCOLN AVE
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City | EASTPOINTE
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State | MI
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Zip | 48021-3062
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Country | US
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Telephone | 313-659-8043
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Fax |
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Authorized Official
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Title or Position | COORDINATOR/OWNER
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Name | EBONY CAMPBELL
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Credential |
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Telephone | 313-659-8043
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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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