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General NPI Number Information
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NPI Number | 1972017499
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Entity Type | Organization
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Legal Business Name | 1ST ASSISTANT HOME HEALTH SERVICES LLC
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Dates
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Enumeration Date | 11/20/2017
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Last Update Date | 09/30/2019
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Provider Practice Location Address
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Address Line | 25820 SOUTHFIELD RD STE 209A
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City | SOUTHFIELD
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State | MI
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Zip | 48075-1826
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Country | US
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Telephone | 314-503-0062
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Fax |
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Provider Business Mailing Address
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Address Line | 25820 SOUTHFIELD RD STE 209
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City | SOUTHFIELD
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State | MI
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Zip | 48075-1828
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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 | EXECUTIVE DIRECTOR
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Name | KELLY BUTLER
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Credential |
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Telephone | 314-503-0062
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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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