Provider Demographics
NPI:1093251795
Name:CARE DIVISON
Entity Type:Organization
Organization Name:CARE DIVISON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXCUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:OGHENEREKE
Authorized Official - Middle Name:LISA
Authorized Official - Last Name:OMAVUEZI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-620-3946
Mailing Address - Street 1:1008 S MILITARY ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-2136
Mailing Address - Country:US
Mailing Address - Phone:734-620-3946
Mailing Address - Fax:
Practice Address - Street 1:1008 S MILITARY ST
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-2136
Practice Address - Country:US
Practice Address - Phone:734-620-3946
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-18
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home