# AILENE'S ROSE COMMUNITY SUPPORT

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

## Provider details

- **NPI number:** 1164219051
- **Authorized official:** PANDORA GAVIN (OWNER)
- **Authorized official phone:** (443) 953-8907

## Contact information

- **Practice address:** 5135 E 13 MILE RD, WARREN, MI 48092-4445
- **Practice address phone:** (443) 953-8907
- **Mailing address:** 5135 E 13 MILE RD, WARREN, MI 48092-4445

## Taxonomy

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

## Other

- **Enumeration date:** 04/23/2025
- **Last updated:** 04/23/2025