Provider Demographics
NPI:1245892223
Name:DEVOTION HOME HEALTH AND PERSONAL CARE SERVICES
Entity type:Organization
Organization Name:DEVOTION HOME HEALTH AND PERSONAL CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MISTY
Authorized Official - Middle Name:S
Authorized Official - Last Name:NOVAKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:810-991-1630
Mailing Address - Street 1:368 BAINTREE BLVD
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48114-5005
Mailing Address - Country:US
Mailing Address - Phone:810-991-1630
Mailing Address - Fax:810-991-1532
Practice Address - Street 1:368 BAINTREE BLVD
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48114-5005
Practice Address - Country:US
Practice Address - Phone:810-991-1630
Practice Address - Fax:810-991-1532
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DEVOTION HOME HEALTH AND PERSONAL CARE SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-07-01
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1265916662OtherNPI