Organization
PURPOSE HOME CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DARRIUS D EDWARDS (EXECUTIVE)
(586) 718-3775
Entity
Organization
Contact information
Practice address
14123 GLENWOOD DR, SHELBY TOWNSHIP, MI 48315-5424
(586) 718-3775
(586) 722-0635
Mailing address
14123 GLENWOOD DRIVE, SHELBY TOWNSHIP, MI 48315-5424
(586) 718-3775
(586) 722-0635
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
0064080
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0064080
—
MI
Enumeration date
11/29/2011
Last updated
11/29/2011
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