Provider Demographics
NPI:1568852127
Name:COFFER'S HOUSING SOLUTIONS
Entity Type:Organization
Organization Name:COFFER'S HOUSING SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BERNICE
Authorized Official - Middle Name:
Authorized Official - Last Name:COFFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-318-7762
Mailing Address - Street 1:4063 W BUENA VISTA ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48238-3203
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4063 W BUENA VISTA ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48238-3203
Practice Address - Country:US
Practice Address - Phone:313-318-7762
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-03
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MINOT REQUIREDOtherNOT REQUIRED