Provider Demographics
NPI:1689078206
Name:DARE CONSULTING GROUP LLC
Entity Type:Organization
Organization Name:DARE CONSULTING GROUP LLC
Other - Org Name:DME MEDICAL SUPPLY SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAUGHHUNN SMALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-282-4900
Mailing Address - Street 1:31600 TELEGRAPH RD STE 120
Mailing Address - Street 2:
Mailing Address - City:BINGHAM FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48025-4370
Mailing Address - Country:US
Mailing Address - Phone:248-282-4900
Mailing Address - Fax:248-498-5960
Practice Address - Street 1:31600 TELEGRAPH RD STE 120
Practice Address - Street 2:
Practice Address - City:BINGHAM FARMS
Practice Address - State:MI
Practice Address - Zip Code:48025-4370
Practice Address - Country:US
Practice Address - Phone:248-282-4900
Practice Address - Fax:248-498-5960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIM295790332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MICV0129013Medicaid