Provider Demographics
NPI:1922366095
Name:BOWER ENTERPRISES II
Entity Type:Organization
Organization Name:BOWER ENTERPRISES II
Other - Org Name:EXPERTCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAXIMORE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:248-205-7204
Mailing Address - Street 1:26645 W 12 MILE RD STE 208
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-7812
Mailing Address - Country:US
Mailing Address - Phone:248-281-4151
Mailing Address - Fax:248-281-4151
Practice Address - Street 1:26645 W 12 MILE RD STE 208
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-7812
Practice Address - Country:US
Practice Address - Phone:248-281-4082
Practice Address - Fax:248-281-4151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-26
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI237751Medicare Oscar/Certification