Organization
ENVISION HOME CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHATIKA COWLING LARSOSA (OWNER)
(248) 934-1370
Entity
Organization
Contact information
Practice address
23071 HAWTHORNE ST, FARMINGTON, MI 48336-3330
(248) 934-1370
Mailing address
35560 GRAND RIVER AVE # 264, FARMINGTON, MI 48335-3123
(248) 934-1370
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
06/04/2022
Last updated
06/04/2022
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