# KEHLANI CARES

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

## Provider details

- **NPI number:** 1275110538
- **Authorized official:** MRS. TRACY D FUENTES (OWNER)
- **Authorized official phone:** (734) 307-5378

## Contact information

- **Practice address:** 1824 15TH ST, WYANDOTTE, MI 48192-3616
- **Practice address phone:** (734) 307-5378
- **Practice address fax:** (734) 638-6005
- **Mailing address:** 14000 DIX TOLEDO RD UNIT 1311, SOUTHGATE, MI 48195-9513
- **Mailing address phone:** (734) 307-5378
- **Mailing address fax:** (734) 638-6005

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171M00000X | Case Manager/Care Coordinator | — | NULL | Yes |
| 171M00000X | Case Manager/Care Coordinator | — | — | Yes |
| 177F00000X | Lodging Provider | — | NULL | — |
| 225700000X | Massage Therapist | — | NULL | — |
| 225700000X | Massage Therapist | — | — | — |
| 251E00000X | Home Health Agency | — | NULL | — |
| 3747A0650X | Attendant Care Provider | — | NULL | — |
| 3747A0650X | Attendant Care Provider | — | — | — |
| 374U00000X | Home Health Aide | — | NULL | — |
| 374U00000X | Home Health Aide | — | — | — |

## Other

- **Enumeration date:** 03/24/2021
- **Last updated:** 03/30/2021