Stacey Junior
Individual provider Active NPI Chore Provider · River Rouge, MI
NPI 1962874156 · NPPES record last updated Oct 27, 2015
Key facts
- NPI
- 1962874156
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chore Provider 372500000X
- Practice address
- 94 E Henry St
River Rouge, MI 48218-1640 - Phone
- (313) 300-9711
- NPI assigned
- Oct 27, 2015
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chore Provider | 372500000X | MI | Yes |
Addresses
Primary practice location
94 E Henry St
River Rouge, MI 48218-1640
Mailing address
94 E Henry St
River Rouge, MI 48218-1640
Other providers in River Rouge, MI
- Home Care Services Mi LLC
- Theresa Jackson
- Dorothy Beatrice Jenkins
- Helene Johnson-Powell
- Batrice Jones II
- Diane Matthewsmatthews01
- Kassie L McKnight
- Charles Chisom Obi
- Peoples Community Medical Center PC
- Majeana Lashay Peterson
All providers in River Rouge, MI · Chore Provider in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 27, 2015. 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.