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Organization
VINCULUM CARE LLC
Active
Organization
VINCULUM CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ELIA EJAZ HUSSAIN (PRESIDENT)
(810) 357-8792
Entity
Organization
Contact information
Practice address
5316 LAKESHORE RD, FORT GRATIOT, MI 48059-3118
(810) 357-8792
Mailing address
5316 LAKESHORE RD, FORT GRATIOT, MI 48059-3118
(810) 357-8792
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
—
—
163W00000X
Registered Nurse
Primary
—
—
163WH0200X
Home Health Registered Nurse
—
—
163WH1000X
Hospice Registered Nurse
—
—
164W00000X
Licensed Practical Nurse
—
—
224Z00000X
Occupational Therapy Assistant
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261Q00000X
Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1083193783
FNP
MI
Enumeration date
06/22/2023
Last updated
11/27/2023
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