Organization
GOLDEN EVOLUTION LLC
Active
Other names
Nurturing Nest MIHP
Organization subpart
No
Provider details
NPI number
Authorized official
LANITA GORDYPULLIAM (OWNER)
(248) 403-4576
Entity
Organization
Contact information
Practice address
15700 W 10 MILE RD, SUITE 115, SOUTHFIELD, MI 48075-2149
(248) 281-3477
(248) 281-5487
Mailing address
15700 W 10 MILE RD, SUITE 115, SOUTHFIELD, MI 48075-2149
(248) 281-3477
(248) 281-5487
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
05/21/2015
Last updated
03/07/2017
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