Provider Demographics
NPI:1558989509
Name:SOUTHEASTERN MICHIGAN NANNIES, LLC
Entity Type:Organization
Organization Name:SOUTHEASTERN MICHIGAN NANNIES, LLC
Other - Org Name:JOVIE OF ANN ARBOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:RAGLAND-KEYS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-761-8393
Mailing Address - Street 1:3913 JACKSON RD
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-1823
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3913 JACKSON RD
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-1823
Practice Address - Country:US
Practice Address - Phone:734-761-8393
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-07
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care