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HUDSON HOME 1 INC NPI 1619452588


NPI Information

NPI: 1619452588
Provider Name: HUDSON HOME 1 INC
Classification: Custodial Care Facility - 311ZA0620X
Entity Type: Organization

Specialization: Adult Care Home

CLIA Number: 23D2206210

Address:
750 VIRGINIA PARK ST
DETROIT, MI
ZIP 48202
Phone: (313) 875-5499
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HUDSON HOME 1 INC is an adult care home custodial care facility in Detroit, MI. The provider is a custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. HUDSON HOME 1 INC NPI is 1619452588. The provider is registered as an organization entity type.

The provider's business location address is:

750 VIRGINIA PARK ST
DETROIT, MI
ZIP 48202-033
Phone: (313) 875-5499
Fax: (313) 875-5499

The provider's authorized official is Lillar M Hudson .
The authorized official title is Administrator and has the following contact phone number (313) 407-3711.

The CLIA number assigned to this NPI record is 23D2206210 - intermediate care facility for mentally retarded with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/26/2018 and was last updated on 9/26/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1311ZA0620XCustodial Care FacilityAdult Care HomeYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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