Provider Demographics
NPI:1538988803
Name:GIFTED CARE AGENCY, LLC
Entity type:Organization
Organization Name:GIFTED CARE AGENCY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JEWEL
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:BUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-480-8232
Mailing Address - Street 1:15900 W 10 MILE RD STE 211
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-2079
Mailing Address - Country:US
Mailing Address - Phone:248-480-8232
Mailing Address - Fax:833-592-0528
Practice Address - Street 1:26677 W 12 MILE RD STE 115
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-1514
Practice Address - Country:US
Practice Address - Phone:248-480-8232
Practice Address - Fax:833-592-0528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-04
Last Update Date:2024-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health