Provider Demographics
NPI:1326757774
Name:STAT CONNECTIONS HOME CARE LLC
Entity Type:Organization
Organization Name:STAT CONNECTIONS HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DARSHAE
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:COLEMAN-WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:947-957-2826
Mailing Address - Street 1:17 GREENWOODE LN # A
Mailing Address - Street 2:
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48340-2259
Mailing Address - Country:US
Mailing Address - Phone:947-957-2826
Mailing Address - Fax:
Practice Address - Street 1:17 GREENWOODE LN # A
Practice Address - Street 2:
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48340-2259
Practice Address - Country:US
Practice Address - Phone:947-957-2826
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-15
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Multi-Specialty
No251J00000XAgenciesNursing Care
No385H00000XRespite Care FacilityRespite Care