1215341276 NPI number — ENRICHED LIFE HOME CARE SERVICES

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215341276 NPI number — ENRICHED LIFE HOME CARE SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ENRICHED LIFE HOME CARE SERVICES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1215341276
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/18/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
15223 FARMINGTON RD
Provider Second Line Business Mailing Address:
SUITE 10
Provider Business Mailing Address City Name:
LIVONIA
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48154-5411
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
734-744-6477
Provider Business Mailing Address Fax Number:
734-437-1178

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
15223 FARMINGTON RD
Provider Second Line Business Practice Location Address:
SUITE 10
Provider Business Practice Location Address City Name:
LIVONIA
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48154-5411
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
734-744-6477
Provider Business Practice Location Address Fax Number:
734-437-1178
Provider Enumeration Date:
06/18/2014

Additional Information

Authorized Official

Authorized Official Last Name:
SLATTON
Authorized Official First Name:
CHRISTINA
Authorized Official Middle Name:
MERRY
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
734-744-6477

Provider Taxonomy Codes

  • Taxonomy code: 253Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com