Individual
RAVEN ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
19177 NEGAUNEE, REDFORD, MI 48240-1637
(734) 312-8968
Mailing address
40315 MICHIGAN AVE, CANTON, MI 48188-2908
(734) 312-8968
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
900079658
MI
Other
Enumeration date
05/11/2026
Last updated
05/11/2026
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