# INTENTIONAL HOME HEALTHCARE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013729193
- **Authorized official:** JASMINE NELSON-BROCK RN (OWNER)
- **Authorized official phone:** (248) 709-1089

## Contact information

- **Practice address:** 20411 W 12 MILE RD STE 207, SOUTHFIELD, MI 48076-6405
- **Practice address phone:** (248) 709-1089
- **Mailing address:** 20411 W 12 MILE RD STE 207, SOUTHFIELD, MI 48076-6405
- **Mailing address phone:** (248) 709-1089

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 01/24/2025
- **Last updated:** 01/24/2025