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Organization
MAVERICK ONE INC
Active
Organization
MAVERICK ONE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAWANDA JEAN GREGORY (OWNER)
(313) 283-3722
Entity
Organization
Contact information
Practice address
900 LINCOLN LN APT 802, DEARBORN, MI 48126-2987
(313) 283-3722
(313) 914-3094
Mailing address
900 LINCOLN LN APT 802, DEARBORN, MI 48126-2987
(313) 283-3722
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
NULL
Other
Enumeration date
02/05/2020
Last updated
02/05/2020
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