Provider Demographics
NPI:1962815480
Name:SCHOLARSTICA HOME CARE SERVICES, LLC
Entity Type:Organization
Organization Name:SCHOLARSTICA HOME CARE SERVICES, LLC
Other - Org Name:SCHOLAR HOME
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNY
Authorized Official - Middle Name:N
Authorized Official - Last Name:AZUMAH-OWOROETOP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-649-2245
Mailing Address - Street 1:5960 BEDFORD ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48224-2651
Mailing Address - Country:US
Mailing Address - Phone:313-649-2245
Mailing Address - Fax:313-649-2347
Practice Address - Street 1:5960 BEDFORD ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48224-2651
Practice Address - Country:US
Practice Address - Phone:313-649-2245
Practice Address - Fax:313-649-2347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-03
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIAS820338940251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services