MEDICARE: JOURNEY CARE CONSULTING, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	163WG0000X	General Practice Registered Nurse
2	174H00000X	Health Educator
3	246Y00000X	Health Information Specialist/Technologist

General Provider Information

NPI Number	:	1003553009
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOURNEY CARE CONSULTING, LLC

Provider Business Mailing Address
First Line	:	4303 WOODHALL ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48224-2222
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2328 E 7 MILE RD
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48234-1304
Country	:	US
Telephone Number	:	313-671-3252
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	YVONNE TAYLOR
Credential	:	NP
Telephone Number	:	313-671-3252

Provider Enumeration Date	:	05/19/2022
Last Update Date	:	05/19/2022

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