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General NPI Number Information
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NPI Number | 1922129972
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Entity Type | Organization
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Legal Business Name | EASTWEST TECHNOLOGIES, LLC
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 11/02/2016
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Provider Practice Location Address
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Address Line | 31201 CHICAGO RD S SUITE B302
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City | WARREN
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State | MI
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Zip | 48093-5527
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Country | US
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Telephone | 586-582-9690
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Fax | 586-582-9590
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Provider Business Mailing Address
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Address Line | 35452 MUSTANG DR
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City | STERLING HEIGHTS
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State | MI
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Zip | 48312-4067
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Country | US
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Telephone | 586-582-9690
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Fax | 586-582-9590
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. BENJAMIN ROA ESPERE IV
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Credential | RPT
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Telephone | 586-489-4638
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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 | 383512826
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License Number State | MI
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