Organization
INTENTIONAL HOME HEALTHCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASMINE NELSON-BROCK RN (OWNER)
(248) 709-1089
Entity
Organization
Contact information
Practice address
20411 W 12 MILE RD STE 207, SOUTHFIELD, MI 48076-6405
(248) 709-1089
Mailing address
20411 W 12 MILE RD STE 207, SOUTHFIELD, MI 48076-6405
(248) 709-1089
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
01/24/2025
Last updated
01/24/2025
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