Provider Demographics
NPI:1275886665
Name:CLOSEST PLACE TO HOME LLC
Entity Type:Organization
Organization Name:CLOSEST PLACE TO HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAVAUGHN
Authorized Official - Middle Name:S
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-350-8698
Mailing Address - Street 1:35630 GRAND RIVER AVE
Mailing Address - Street 2:SUITE 210A
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48335-3133
Mailing Address - Country:US
Mailing Address - Phone:313-350-8698
Mailing Address - Fax:248-427-1165
Practice Address - Street 1:19810 WESTMORELAND RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48219-5106
Practice Address - Country:US
Practice Address - Phone:313-350-8698
Practice Address - Fax:248-427-1165
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-22
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility