Organization
GOODWILL HOME CARE SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LUZVIMIN L CUNANAN RN (ADMINISTRATOR)
(248) 307-1772
Entity
Organization
Contact information
Practice address
31115 DEQUINDRE RD, MADISON HEIGHTS, MI 48071-1566
(248) 307-1772
(248) 307-1609
Mailing address
31115 DEQUINDRE RD, MADISON HEIGHTS, MI 48071-1805
(248) 307-1772
(248) 307-1609
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
237522
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OE834
BCBSM
MI
Enumeration date
02/15/2007
Last updated
09/23/2008
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