Provider Demographics
NPI:1518251008
Name:ETNICITY LLC
Entity Type:Organization
Organization Name:ETNICITY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HEARD
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:313-310-9241
Mailing Address - Street 1:22339 HAMPTON COURT
Mailing Address - Street 2:JOYCE HEARD
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034
Mailing Address - Country:US
Mailing Address - Phone:313-310-9241
Mailing Address - Fax:248-327-7713
Practice Address - Street 1:22339 HAMPTON COURT
Practice Address - Street 2:JOYCE HEARD
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-2123
Practice Address - Country:US
Practice Address - Phone:313-310-9241
Practice Address - Fax:248-327-7713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-02
Last Update Date:2011-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care