Organization
TDAL HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HAROLD BRAGGS JR. (PRESIDENT)
(313) 461-7836
Entity
Organization
Contact information
Practice address
19510 BURLINGTON DR, DETROIT, MI 48203-1454
(313) 461-7836
Mailing address
19510 BURLINGTON DR, DETROIT, MI 48203-1454
(313) 461-7836
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
802224649
STATE ID
MI
Enumeration date
12/02/2018
Last updated
12/02/2018
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