Provider Demographics
NPI:1710730031
Name:RAYS OF IRIS HOME CARE AGENCY
Entity Type:Organization
Organization Name:RAYS OF IRIS HOME CARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SUMAYAH
Authorized Official - Middle Name:
Authorized Official - Last Name:WAKELY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-972-7132
Mailing Address - Street 1:6689 ORCHARD LAKE RD # 142
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-3404
Mailing Address - Country:US
Mailing Address - Phone:248-972-7132
Mailing Address - Fax:
Practice Address - Street 1:21701 W 11 MILE RD STE 8
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-3713
Practice Address - Country:US
Practice Address - Phone:248-972-7132
Practice Address - Fax:248-262-6888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No385H00000XRespite Care FacilityRespite Care