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Individual

MS. RENITA ROBERTSON-STREET

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
19454 STAHELIN AVE, DETROIT, MI 48219-2155
(248) 346-1263
Mailing address
19454 STAHELIN AVE, DETROIT, MI 48219-2155
(248) 346-1263

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
251B00000X
Case Management Agency
Primary
251E00000X
Home Health Agency
251G00000X
Community Based Hospice Care Agency
253Z00000X
In Home Supportive Care Agency
332U00000X
Home Delivered Meals
347C00000X
Private Vehicle
385H00000X
Respite Care
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care

Other

Enumeration date
01/06/2025
Last updated
01/06/2025
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