Active NPI
Official Care Connection LLC
- Home Health Agency
- Roseville, MI
National Provider Identifier
1801670237
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Legal business name
- OFFICIAL CARE CONNECTION LLC
- Doing business as
- official care connection LLC
- Practice address
- 25296 Ronald St
Roseville, MI 48066-4461 - Phone
- (313) 717-2598
- NPI assigned
- Aug 24, 2023
- Organization subpart
- Yes
- Parent organization
- ONLY FAMILY CONNECTIONS LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Hezekiah Dwayne Clark
- Title
- Operating Care Provider
- Phone
- (313) 717-2598
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Primary |
Addresses
Primary practice location
25296 Ronald St
Roseville, MI 48066-4461
Mailing address
2222 Ferry Park St # 1206
Detroit, MI 48208-1384
Phone (313) 639-8117
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8132125 | Medicaid | MI |
Other names 1
- official care connection LLC
National Provider Directory
National Provider Directory- Part of
- Official Care Connection LLC
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1692835200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1693008000000",
"number": "1801670237",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2222 FERRY PARK ST # 1206",
"city": "DETROIT",
"state": "MI",
"postal_code": "482081384",
"telephone_number": "313-639-8117"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25296 RONALD ST",
"city": "ROSEVILLE",
"state": "MI",
"postal_code": "480664461",
"telephone_number": "313-717-2598"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "OFFICIAL CARE CONNECTION LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "ONLY FAMILY CONNECTIONS LLC",
"enumeration_date": "2023-08-24",
"last_updated": "2023-08-26",
"certification_date": "2023-08-26",
"status": "A",
"authorized_official_last_name": "CLARK",
"authorized_official_first_name": "HEZEKIAH",
"authorized_official_middle_name": "DWAYNE",
"authorized_official_title_or_position": "OPERATING CARE PROVIDER",
"authorized_official_telephone_number": "313-717-2598",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8132125",
"state": "MI"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "official care connection LLC",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "official care connection LLC",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Roseville, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.