# MIBELL HOME HEALTH CARE AGENCY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** mibell home health care agency
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710553839
- **Authorized official:** BRITTIANEE PETTAWAY (OWNER)
- **Authorized official phone:** (248) 929-4645

## Contact information

- **Practice address:** 28986 SUGAR ISLAND CT, GIBRALTAR, MI 48173-9578
- **Practice address phone:** (248) 929-4645
- **Mailing address:** 28986 SUGAR ISLAND CT, GIBRALTAR, MI 48173-9578
- **Mailing address phone:** (248) 929-4645

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 164W00000X | Licensed Practical Nurse | — | NULL | Yes |
| 164W00000X | Licensed Practical Nurse | — | — | Yes |

## Other

- **Enumeration date:** 05/29/2021
- **Last updated:** 05/15/2024