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General NPI Number Information
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NPI Number | 1962383497
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Entity Type | Organization
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Legal Business Name | 198275 MI LLC
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Dates
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Enumeration Date | 09/10/2025
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Last Update Date | 09/10/2025
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Provider Practice Location Address
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Address Line | 220 SOUTH MAIN ST
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City | ROYAL OAK
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State | MI
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Zip | 48067
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Country | US
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Telephone | 313-762-4211
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Fax | 313-762-4211
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Provider Business Mailing Address
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Address Line | 8063 CHALLIS RD STE 1031
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City | BRIGHTON
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State | MI
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Zip | 48116-7446
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Country | US
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Telephone | 313-762-4211
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MS. ANTOINETTE HENRY
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Credential |
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Telephone | 313-762-4211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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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 | 315D00000X
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Taxonomy Name | Inpatient Hospice
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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 | 374U00000X
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Taxonomy Name | Home Health Aide
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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 | 385H00000X
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Taxonomy Name | Respite Care
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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 | 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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