Provider Demographics
NPI:1669046173
Name:GRANNY'S HELPERS
Entity type:Organization
Organization Name:GRANNY'S HELPERS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/ OPERATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LAKESHA
Authorized Official - Middle Name:STARR
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:HOME HEALTH AIDE
Authorized Official - Phone:313-723-7461
Mailing Address - Street 1:11000 W MCNICHOLS RD SUITE 323 #1366
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48221-2393
Mailing Address - Country:US
Mailing Address - Phone:313-723-7461
Mailing Address - Fax:313-836-1883
Practice Address - Street 1:11000 W MCNICHOLS RD
Practice Address - Street 2:SUITE 323#1366
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48221-2393
Practice Address - Country:US
Practice Address - Phone:313-723-7461
Practice Address - Fax:313-836-1886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-19
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty
No164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty
No385H00000XRespite Care FacilityRespite CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI118128767OtherDUN NUMBER
MI1760056279Medicaid
MI1598446007Medicaid
MI1669046173Medicaid
MIED1SRNSVN271OtherEDI