MEDICARE: GODS CARE LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1306431184
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GODS CARE LLC

Provider Business Mailing Address
First Line	:	46290 HAMPTON DR
Second Line	:
City	:	SHELBY TWP
State	:	MI
Zip	:	48315-5608
Country	:	US
Telephone Number	:	770-773-0008
Fax Number	:

Provider Business Practice Location Address
First Line	:	46290 HAMPTON DR
Second Line	:
City	:	SHELBY TWP
State	:	MI
Zip	:	48315-5608
Country	:	US
Telephone Number	:	770-773-0008
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MARK BSHARA
Credential	:
Telephone Number	:	770-773-0008

Provider Enumeration Date	:	03/04/2021
Last Update Date	:	03/04/2021

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Directions to “GODS CARE LLC ” Practice Location

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