Provider Demographics
NPI:1053144907
Name:ATHOMECARE4SENIORS
Entity type:Organization
Organization Name:ATHOMECARE4SENIORS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OWIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:FREDERICK-YUILLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-742-8613
Mailing Address - Street 1:PO BOX 39011
Mailing Address - Street 2:
Mailing Address - City:REDFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48239-0011
Mailing Address - Country:US
Mailing Address - Phone:313-742-8613
Mailing Address - Fax:313-766-4520
Practice Address - Street 1:13901 ARDMORE ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48227-3108
Practice Address - Country:US
Practice Address - Phone:313-742-8613
Practice Address - Fax:313-766-4520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-24
Last Update Date:2024-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care