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Organization
RESTIVA CARE PROVIDERS LLC
Active
Organization
RESTIVA CARE PROVIDERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHANNIE ODAMS LPN (ADMINISTRATOR/OWNER)
(734) 521-1577
Entity
Organization
Contact information
Practice address
40075 EATON STREET, APT. 203, CANTON, MI 48187
(810) 588-1595
Mailing address
847 SUMPTER ROAD, #436, BELLEVILLE, MI 48111
(810) 588-1595
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
—
NULL
163W00000X
Registered Nurse
—
—
163WH0200X
Home Health Registered Nurse
—
NULL
163WW0000X
Wound Care Registered Nurse
—
NULL
163WW0000X
Wound Care Registered Nurse
—
—
164W00000X
Licensed Practical Nurse
—
NULL
164W00000X
Licensed Practical Nurse
—
—
171M00000X
Case Manager/Care Coordinator
—
NULL
171M00000X
Case Manager/Care Coordinator
—
—
251B00000X
Case Management Agency
—
NULL
251E00000X
Home Health Agency
Primary
—
NULL
251F00000X
Home Infusion Agency
—
NULL
251J00000X
Nursing Care Agency
—
NULL
253Z00000X
In Home Supportive Care Agency
—
NULL
332U00000X
Home Delivered Meals
—
NULL
347C00000X
Private Vehicle
—
NULL
372500000X
Chore Provider
—
NULL
372500000X
Chore Provider
—
—
372600000X
Adult Companion
—
NULL
372600000X
Adult Companion
—
—
385H00000X
Respite Care
—
NULL
Other
Enumeration date
11/04/2024
Last updated
11/13/2024
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