Organization
A TABLE PREPARED HOME CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CATRINA MIMS (ADMINISTRATOR)
(248) 378-7145
Entity
Organization
Contact information
Practice address
17669 MCINTYRE ST, DETROIT, MI 48219-2369
(248) 378-7145
Mailing address
17669 MCINTYRE ST, DETROIT, MI 48219-2369
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
06/27/2025
Last updated
06/27/2025
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