Organization · NPI-2

A Table Prepared Home Care

In Home Supportive Care · Detroit, MI

NPI number1386532240
StatusActive
Last updated in NPPESJun 27, 2025

Details

NPI
1386532240
Entity type
Organization (NPI-2)
Legal business name
A Table Prepared Home Care
Organization subpart
No
Enumeration date
Jun 27, 2025
Certification date
Jun 26, 2025
Last updated
Jun 27, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
253Z00000X In Home Supportive Care––Yes

Practice location

17669 Mcintyre St
Detroit, MI 48219-2369

Phone 248-378-7145

Mailing address

17669 Mcintyre St
Detroit, MI 48219-2369

Authorized official

Catrina Mims
Administrator
2483787145

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