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Organization

MARIA'S TENDER LOVING HOME CARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MISS KENYETTE MCCUNE HOME HEALTH AIDE (AGENCY/OWNER)
(313) 828-0583
Entity
Organization

Contact information

Practice address
7233 VOERNER AVE, CENTER LINE, MI 48015-1810
(313) 828-0583
(313) 372-2794
Mailing address
7233 VOERNER AVE, CENTER LINE, MI 48015-1810
(313) 828-0583
(313) 372-2794

Taxonomy

Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
155482
MI
Enumeration date
10/20/2014
Last updated
10/20/2014
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