Active NPI
Renita Robertson-Street
- Case Management Agency
- Detroit, MI
National Provider Identifier
1124837885
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Management Agency
- Practice address
- 19454 Stahelin Ave
Detroit, MI 48219-2155 - Phone
- (248) 346-1263
- NPI assigned
- Jan 6, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 9
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | |||
| Home Health Agency | 251E00000X | |||
| Community Based Hospice Care Agency | 251G00000X | |||
| In Home Supportive Care Agency | 253Z00000X | |||
| Home Delivered Meals | 332U00000X | |||
| Private Vehicle | 347C00000X | |||
| Respite Care | 385H00000X | |||
| Child Intellectual and/or Developmental Disabilities Respite Care | 385HR2060X | |||
| Case Management Agency | 251B00000X | Primary |
Addresses
Primary practice location
19454 Stahelin Ave
Detroit, MI 48219-2155
Mailing address
19454 Stahelin Ave
Detroit, MI 48219-2155
Phone (248) 346-1263
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1736121600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736121600000",
"number": "1124837885",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19454 STAHELIN AVE",
"city": "DETROIT",
"state": "MI",
"postal_code": "482192155",
"telephone_number": "248-346-1263"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19454 STAHELIN AVE",
"city": "DETROIT",
"state": "MI",
"postal_code": "482192155",
"telephone_number": "248-346-1263"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTSON-STREET",
"first_name": "RENITA",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-01-06",
"last_updated": "2025-01-06",
"certification_date": "2025-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": null,
"license": null,
"primary": false
},
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "332U00000X",
"taxonomy_group": "",
"desc": "Home Delivered Meals",
"state": null,
"license": null,
"primary": false
},
{
"code": "347C00000X",
"taxonomy_group": "",
"desc": "Private Vehicle",
"state": null,
"license": null,
"primary": false
},
{
"code": "385H00000X",
"taxonomy_group": "",
"desc": "Respite Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "385HR2060X",
"taxonomy_group": "",
"desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
"state": null,
"license": null,
"primary": false
},
{
"code": "251B00000X",
"taxonomy_group": "",
"desc": "Case Management",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.