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Organization
FIVE STAR MEDICAL LLC
Active
Organization
FIVE STAR MEDICAL LLC
Active
Other names
Five Star Medical
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KADEJAH DORENA COON (CEO)
(313) 407-2088
Entity
Organization
Contact information
Practice address
5260 IVANHOE ST, DETROIT, MI 48204-3632
(313) 407-2088
Mailing address
5260 IVANHOE ST, DETROIT, MI 48204-3632
(313) 407-2088
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
NULL
253J00000X
Foster Care Agency
—
NULL
253Z00000X
In Home Supportive Care Agency
—
NULL
310400000X
Assisted Living Facility
—
NULL
Other
Enumeration date
04/03/2024
Last updated
04/03/2024
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