MEDICARE: FAMILY'S R US

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	4704271302	MI

General Provider Information

NPI Number	:	1366727711
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY'S R US

Provider Business Mailing Address
First Line	:	2785 E GRAND BLVD
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48211-2003
Country	:	US
Telephone Number	:	313-623-1555
Fax Number	:	313-872-7832

Provider Business Practice Location Address
First Line	:	2785 E GRAND BLVD
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48211-2003
Country	:	US
Telephone Number	:	313-623-1555
Fax Number	:	313-872-7832

Authorized Official
Title or Position	:	REGISTERED NURSE/OWNER
Name	:	CARYN DENISE CLAYTON
Credential	:	REGISTERED NURSE
Telephone Number	:	313-728-3736

Provider Enumeration Date	:	10/17/2011
Last Update Date	:	01/12/2012

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Directions to “FAMILY'S R US ” Practice Location

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