Organization
HOME VISITING PROVIDERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE JAWAD (BILLER)
(313) 415-1515
Entity
Organization
Contact information
Practice address
7542 WYOMING ST, DEARBORN, MI 48126-1690
(313) 415-1515
Mailing address
7542 WYOMING ST, DEARBORN, MI 48126-1690
(313) 415-1515
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
10/13/2020
Last updated
07/01/2021
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