Provider Demographics
NPI:1639938491
Name:HOMESELEVEN
Entity Type:Organization
Organization Name:HOMESELEVEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LECHELL
Authorized Official - Middle Name:THEALINE
Authorized Official - Last Name:HUDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-477-1615
Mailing Address - Street 1:672 FAIRWOOD ST
Mailing Address - Street 2:
Mailing Address - City:INKSTER
Mailing Address - State:MI
Mailing Address - Zip Code:48141-1229
Mailing Address - Country:US
Mailing Address - Phone:313-477-1615
Mailing Address - Fax:
Practice Address - Street 1:3317 S GREYFRIAR ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48217-1038
Practice Address - Country:US
Practice Address - Phone:313-477-1615
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-15
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care