Organization
HOME AWAY FROM HOME GROUP HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE WALKER (OWNER)
(313) 929-9750
Entity
Organization
Contact information
Practice address
23300 PROVIDENCE DR APT 703, SOUTHFIELD, MI 48075-3675
(313) 929-9750
Mailing address
23300 PROVIDENCE DR APT 703, SOUTHFIELD, MI 48075-3675
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
03/25/2026
Last updated
03/25/2026
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