# PRIMAL HEALTHCARE SERVICES, LLC

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

## Provider details

- **NPI number:** 1104298512
- **Authorized official:** LISA MORTEN (AUTHORIZED AGENT)
- **Authorized official phone:** (313) 355-2841

## Contact information

- **Practice address:** 18530 MACK AVE \# 454, GROSSE POINTE FARMS, MI 48236-3254
- **Practice address phone:** (313) 884-8440
- **Mailing address:** 18530 MACK AVE \# 454, GROSSE POINTE FARMS, MI 48236-3254

## Taxonomy

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

## Other

- **Enumeration date:** 10/24/2015
- **Last updated:** 06/14/2016