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General NPI Number Information
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NPI Number | 1912896796
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Entity Type | Organization
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Legal Business Name | RADIANT CARE LLC
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Dates
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Enumeration Date | 06/28/2025
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Last Update Date | 06/28/2025
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Provider Practice Location Address
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Address Line | 17800 NORTHLAND PARK CT STE 104
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City | SOUTHFIELD
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State | MI
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Zip | 48075-4304
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Country | US
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Telephone | 517-366-1447
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Fax |
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Provider Business Mailing Address
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Address Line | 15900 W 10 MILE RD STE 211
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City | SOUTHFIELD
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State | MI
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Zip | 48075-2079
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | ROCHELLE T
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Credential |
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Telephone | 517-366-1447
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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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Taxonomy #2
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 225CX0006X
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Taxonomy Name | Orientation and Mobility Training Rehabilitation Counselor
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number |
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License Number State |
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