Organization
PHOENIX WINGS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GWENDOLYN TURNER (OWNER)
(313) 574-0795
Entity
Organization
Contact information
Practice address
2222 LOTHROP ST, DETROIT, MI 48206-2672
(313) 574-0795
(313) 557-5129
Mailing address
18701 GRAND RIVER AVE STE 207, DETROIT, MI 48223-2214
(313) 574-0795
(313) 557-5129
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
07/11/2018
Last updated
07/11/2018
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