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Individual

MALINDA LEWIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
19184 RUTHERFORD ST, DETROIT, MI 48235-2345
(313) 492-8566
Mailing address
1887 YOSEMITE BLVD, 23, BIRMINGHAM, MI 48009-6549
(313) 492-8566

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
MI
251E00000X
Home Health Agency
Primary
251S00000X
Community/Behavioral Health Agency
253J00000X
Foster Care Agency

Other

Enumeration date
05/20/2015
Last updated
05/20/2015
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