Provider Demographics
NPI:1215361480
Name:DAWN OF LOVE IN CARE TOO
Entity Type:Organization
Organization Name:DAWN OF LOVE IN CARE TOO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:S
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-243-4557
Mailing Address - Street 1:19184 RUTHERFORD ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48235-2345
Mailing Address - Country:US
Mailing Address - Phone:313-243-4557
Mailing Address - Fax:313-582-4286
Practice Address - Street 1:19184 RUTHERFORD ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48235-2345
Practice Address - Country:US
Practice Address - Phone:313-243-4557
Practice Address - Fax:313-582-4286
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DAWN OF LOVE IN CARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-08-23
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X, 253Z00000X, 311ZA0620X
MI311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1215361480OtherNPI