# PRIME CARE MANOR LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972332294
- **Authorized official:** SHEMELIA BURDETT-FOSTER (DIRECTOR/CEO)
- **Authorized official phone:** (313) 720-1702

## Contact information

- **Practice address:** 554 SUPERIOR ST, RIVER ROUGE, MI 48218-1148
- **Practice address phone:** (313) 720-1702
- **Mailing address:** PO BOX 47252, OAK PARK, MI 48237-4952
- **Mailing address phone:** (313) 720-1702

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | — |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 07/26/2024
- **Last updated:** 03/20/2026