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Organization

PRISTINE HOME CARE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARAEA TUTSON RN (OWNER)
(248) 595-0322
Entity
Organization

Contact information

Practice address
3200 GREENFIELD RD STE 300, DEARBORN, MI 48120-1805
(248) 595-0322
(248) 595-0322
Mailing address
2640 COLLEGEWOOD ST, YPSILANTI, MI 48197-1745
(248) 595-0322
(248) 595-0322

Taxonomy

Speciality
Code
Description
License number
State
174200000X
Meals Provider
251B00000X
Case Management Agency
251E00000X
Home Health Agency
Primary
251J00000X
Nursing Care Agency
251S00000X
Community/Behavioral Health Agency
251T00000X
PACE Provider Organization
253J00000X
Foster Care Agency
253Z00000X
In Home Supportive Care Agency
261QC1500X
Community Health Clinic/Center
310400000X
Assisted Living Facility
311ZA0620X
Adult Care Home Facility
3140N1450X
Pediatric Skilled Nursing Facility
343900000X
Non-emergency Medical Transport (VAN)
385H00000X
Respite Care
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1215434956
NPI
MI
01
1821551425
NPI
MI
Enumeration date
04/10/2019
Last updated
01/24/2023
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