Organization
SHANNY'S HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ARECIA PATRICE LOVE (OWNER)
(586) 443-3334
Entity
Organization
Contact information
Practice address
19194 PACKARD ST, DETROIT, MI 48234-3106
(586) 443-3334
(866) 243-4640
Mailing address
19194 PACKARD ST, DETROIT, MI 48234-3106
(586) 443-3334
(866) 243-4640
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1194001727
HOME CARE
FL
Enumeration date
04/19/2018
Last updated
04/18/2022
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