Provider Demographics
NPI:1083313456
Name:HEAL DETROIT N.O.W
Entity Type:Organization
Organization Name:HEAL DETROIT N.O.W
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAKEISHA
Authorized Official - Middle Name:MONEIK
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-445-0297
Mailing Address - Street 1:13935 COYLE ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48227-2534
Mailing Address - Country:US
Mailing Address - Phone:248-445-0297
Mailing Address - Fax:
Practice Address - Street 1:25524 LAWN ST APT B110
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48066-3883
Practice Address - Country:US
Practice Address - Phone:248-835-3663
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-24
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health