Delecia O Clark
Individual provider Active NPI In Home Supportive Care Agency · River Rouge, MI
NPI 1558049171 · NPPES record last updated Jul 7, 2023
Key facts
- NPI
- 1558049171
- Entity type
- Individual (NPI type 1)
- Primary specialty
- In Home Supportive Care Agency 253Z00000X
- Practice address
- 18 Cora St
River Rouge, MI 48218-1202 - Phone
- (313) 996-9111
- NPI assigned
- Jul 5, 2023
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Truly Divine Home Care Agency, LLC | In Home Supportive Care | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| In Home Supportive Care Agency | 253Z00000X | Yes |
Addresses
Primary practice location
18 Cora St
River Rouge, MI 48218-1202
Mailing address
18 Cora St
River Rouge, MI 48218-1202
Phone (313) 996-9111
Other providers in River Rouge, MI
- Brightsmiles
- Colleen Marie Bryant
- Quanesia Campbell
- Emilio Cardona-Ortiz
- City of River Rouge Fire Dept
- CLW Adult Day Care Service LLC
- Detroit Second Chance Inc
- Down River X-Press LLC
- Eliza Home Care Services, Inc
- Mahmoud Mohamad Elzaghir
All providers in River Rouge, MI · In Home Supportive Care Agency in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 7, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.