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Organization
PRIMARY CARE HOME SERVICES, INC
Active
Organization
PRIMARY CARE HOME SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LAYNETTE GOUDY-EGGER NURSE PRACTITIONER (ADMINISTRATOR)
(313) 870-9260
Entity
Organization
Contact information
Practice address
2990 W GRAND BLVD, SUITE 307, DETROIT, MI 48202-3041
(313) 870-9260
(313) 870-9266
Mailing address
2990 W GRAND BLVD, SUITE 307, DETROIT, MI 48202-3041
(313) 870-9260
(313) 870-9266
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
05/15/2012
Last updated
05/15/2012
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