Provider Demographics
NPI:1558614404
Name:PASSIONATE CARE LLC
Entity Type:Organization
Organization Name:PASSIONATE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:OLUBUSOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:OGUNDAISI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-358-0974
Mailing Address - Street 1:26153 COLGATE ST
Mailing Address - Street 2:
Mailing Address - City:INKSTER
Mailing Address - State:MI
Mailing Address - Zip Code:48141-3279
Mailing Address - Country:US
Mailing Address - Phone:734-358-0974
Mailing Address - Fax:734-337-8177
Practice Address - Street 1:26153 COLGATE ST
Practice Address - Street 2:
Practice Address - City:INKSTER
Practice Address - State:MI
Practice Address - Zip Code:48141-3279
Practice Address - Country:US
Practice Address - Phone:734-358-0974
Practice Address - Fax:734-337-8177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-16
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home