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Organization
HEAL WELL DETROIT LLC
Active
Organization
HEAL WELL DETROIT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DESTINY COUNTRYMAN (OWNER)
(510) 424-4255
Entity
Organization
Contact information
Practice address
22243 FENKELL ST, DETROIT, MI 48223-1534
(510) 424-4255
Mailing address
22243 FENKELL ST, DETROIT, MI 48223-1534
(510) 424-4255
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
—
NULL
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251E00000X
Home Health Agency
—
—
261QA0600X
Adult Day Care Clinic/Center
Primary
—
NULL
385H00000X
Respite Care
—
NULL
385H00000X
Respite Care
Primary
—
—
Other
Enumeration date
11/11/2025
Last updated
10/01/2026
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