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General NPI Number Information
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NPI Number | 1871928200
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Entity Type | Organization
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Legal Business Name | MANOR HOUSE I.D.L.S.
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Dates
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Enumeration Date | 09/04/2013
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Last Update Date | 09/04/2013
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Provider Practice Location Address
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Address Line | 21700 NORTHWESTERN HWY SUITE 880
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City | SOUTHFIELD
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State | MI
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Zip | 48075-4906
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Country | US
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Telephone | 888-505-5916
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Fax | 313-450-4533
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Provider Business Mailing Address
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Address Line | 21700 NORTHWESTERN HWY SUITE 880
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City | SOUTHFIELD
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State | MI
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Zip | 48075-4906
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Country | US
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Telephone | 888-505-5916
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Fax | 313-450-4533
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Authorized Official
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Title or Position | CEO
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Name | MS. VALARY JOYCE-EWINGS
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Credential |
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Telephone | 888-505-5916
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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