Organization
-
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASMINE JOHNSON (OWNER)
(313) 588-4977
Entity
Organization
Contact information
Practice address
13850 CAMBRIDGE ST APT 116, SOUTHGATE, MI 48195-3104
(313) 588-4977
Mailing address
13850 CAMBRIDGE ST APT 116, SOUTHGATE, MI 48195-3104
(313) 588-4977
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
06/30/2020
Last updated
06/30/2020
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