Mavis Home Care LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

144596 Issued in MI

Legal business name

MAVIS HOME CARE LLC

Practice address

8325 E Jefferson Ave # 104
Detroit, MI 48214-2797

Phone

(313) 454-3150

Fax

(313) 454-3150

NPI assigned

Mar 12, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Vicky Wardford Polk

Title

Member

Phone

(313) 454-3150

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1394582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394582400000",
    "number": "1831515089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8325 E JEFFERSON AVE # 104",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482142797",
            "telephone_number": "313-454-3150",
            "fax_number": "313-454-3150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8325 E JEFFERSON AVE # 104",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482142797",
            "telephone_number": "313-454-3150",
            "fax_number": "313-454-3150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAVIS HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-12",
        "last_updated": "2014-03-12",
        "status": "A",
        "authorized_official_last_name": "POLK",
        "authorized_official_first_name": "VICKY",
        "authorized_official_middle_name": "WARDFORD",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "313-454-3150",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "MI",
            "license": "144596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Ann Maul, PTA
• Elicia Jane Mauldin
• Margaret D Maurer, LMSW
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• Jordan Maust, DO
• Sam Mawari, PHARMD
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• Alicia Irene Maximuk

• In Home Supportive Care Agency in Detroit, MI
• Providers in Detroit, MI by specialty
• In Home Supportive Care Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.