Provider Demographics
NPI:1568927317
Name:TRUSTCARE GROUP HOME, INC.
Entity Type:Organization
Organization Name:TRUSTCARE GROUP HOME, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:OGBEIFUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-213-6723
Mailing Address - Street 1:15565 NORTHLAND DR W STE 604
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-5319
Mailing Address - Country:US
Mailing Address - Phone:313-213-6723
Mailing Address - Fax:
Practice Address - Street 1:15565 NORTHLAND DR W STE 604
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-5319
Practice Address - Country:US
Practice Address - Phone:313-213-6723
Practice Address - Fax:248-569-1112
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRUSTCARE GROUP HOME, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-02-06
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care