Organization
FIVE STAR MEDICAL LLC
Active
Other names
Five Star Medical
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KADEJAH DORENA COON (CEO)
(313) 407-2088
Entity
Organization
Contact information
Practice address
5260 IVANHOE ST, DETROIT, MI 48204-3632
(313) 407-2088
Mailing address
5260 IVANHOE ST, DETROIT, MI 48204-3632
(313) 407-2088
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
253J00000X
Foster Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
310400000X
Assisted Living Facility
—
—
Other
Enumeration date
04/03/2024
Last updated
04/03/2024
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