MEDICARE: LUCY CARES HOME HEALTH 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1932739752
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LUCY CARES HOME HEALTH CARE LLC

Provider Business Mailing Address
First Line	:	3651 BUCKINGHAM AVE
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48224-3534
Country	:	US
Telephone Number	:	313-662-4534
Fax Number	:

Provider Business Practice Location Address
First Line	:	3651 BUCKINGHAM AVE
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48224-3534
Country	:	US
Telephone Number	:	313-662-4534
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	MRS. LUCRETIA SPILLMAN-RHODES
Credential	:
Telephone Number	:	313-662-4534

Provider Enumeration Date	:	01/21/2020
Last Update Date	:	01/21/2020

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