Provider Demographics
NPI:1558054551
Name:UNIVERSALN
Entity Type:Organization
Organization Name:UNIVERSALN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-812-6973
Mailing Address - Street 1:7906 N 39TH ST
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:MI
Mailing Address - Zip Code:49012-9714
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7906 N 39TH ST
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:MI
Practice Address - Zip Code:49012-9714
Practice Address - Country:US
Practice Address - Phone:734-812-6973
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSALNURSING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-05-26
Last Update Date:2023-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty
No164X00000XNursing Service ProvidersLicensed Vocational NurseGroup - Multi-Specialty
No171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
No3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, PediatricGroup - Multi-Specialty
No364SH0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistHome HealthGroup - Multi-Specialty