Provider Demographics
NPI:1275192247
Name:GREATER METRO DETROIT SENIOR ASSISTANCE LLC
Entity Type:Organization
Organization Name:GREATER METRO DETROIT SENIOR ASSISTANCE LLC
Other - Org Name:VISITING ANGELS SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:KASLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-623-7999
Mailing Address - Street 1:6060 DIXIE HWY STE E
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48346-3476
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6060 DIXIE HWY STE E
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:MI
Practice Address - Zip Code:48346-3476
Practice Address - Country:US
Practice Address - Phone:248-623-7999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-12
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Single Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MINONEOtherWE DO NOT HAVE ANY ADDITIONAL IDENTIFIERS