RESTIVA CARE PROVIDERS LLC NPI 1902629439

NPI Information

  • NPI: 1902629439
  • Provider Name: RESTIVA CARE PROVIDERS LLC
  • Classification: Home Health - 251E00000X
  • Entity Type: Organization
  • Address: 40075 EATON STREET
    APT. 203
    CANTON, MI
    ZIP 48187
  • Phone: (810) 588-1595

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NPI Details

RESTIVA CARE PROVIDERS LLC is a home health in Canton, MI. The provider is a public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. RESTIVA CARE PROVIDERS LLC NPI is 1902629439. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

40075 EATON STREET
APT. 203
CANTON, MI
ZIP 48187
Phone: (810) 588-1595

The provider's authorized official is Channie Odams .
The authorized official title is Administrator/owner and has the following contact phone number (734) 521-1577.

The enumeration date for this NPI number is 11/4/2024 and was last updated on 11/13/2024.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1163W00000XRegistered NurseNo
2163WH0200XRegistered NurseHome HealthNo
3163WW0000XRegistered NurseWound CareNo
4164W00000XLicensed Practical NurseNo
5171M00000XCase Manager/Care CoordinatorNo
6251B00000XCase ManagementNo
7251E00000XHome HealthYes
8251F00000XHome InfusionNo
9251J00000XNursing CareNo
10253Z00000XIn Home Supportive CareNo
11332U00000XHome Delivered MealsNo
12347C00000XPrivate VehicleNo
13372500000XChore ProviderNo
14372600000XAdult CompanionNo
15385H00000XRespite CareNo

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: 11/21/2025

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