Provider Demographics
NPI:1356835995
Name:DANI'S CLOSET HOMECARE SERVICES
Entity Type:Organization
Organization Name:DANI'S CLOSET HOMECARE SERVICES
Other - Org Name:DANIELLE MCSPADDEN
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:ALICIA
Authorized Official - Last Name:MCSPADDEN
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:586-443-6559
Mailing Address - Street 1:31807 RYAN RD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48092-3769
Mailing Address - Country:US
Mailing Address - Phone:586-443-6559
Mailing Address - Fax:
Practice Address - Street 1:31807 RYAN RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48092-3769
Practice Address - Country:US
Practice Address - Phone:586-443-6559
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-18
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI00955859251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI=========Medicaid