Provider Demographics
NPI:1144707928
Name:RETIN CARE-2 INC
Entity type:Organization
Organization Name:RETIN CARE-2 INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:OSARETIN
Authorized Official - Middle Name:
Authorized Official - Last Name:UWAIFO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-478-1734
Mailing Address - Street 1:17471 OLYMPIA
Mailing Address - Street 2:
Mailing Address - City:REDFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48240-2141
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17471 OLYMPIA
Practice Address - Street 2:
Practice Address - City:REDFORD
Practice Address - State:MI
Practice Address - Zip Code:48240-2141
Practice Address - Country:US
Practice Address - Phone:313-478-1734
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-24
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care