Provider Demographics
NPI:1184416901
Name:INKSTER COMMUNITY RESOURCE & REFERRAL CENTER, LLC
Entity type:Organization
Organization Name:INKSTER COMMUNITY RESOURCE & REFERRAL CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:SLEDGE
Authorized Official - Suffix:
Authorized Official - Credentials:MHP
Authorized Official - Phone:313-784-1032
Mailing Address - Street 1:3760 SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:INKSTER
Mailing Address - State:MI
Mailing Address - Zip Code:48141-2922
Mailing Address - Country:US
Mailing Address - Phone:313-784-1032
Mailing Address - Fax:313-784-1032
Practice Address - Street 1:3801 INKSTER RD
Practice Address - Street 2:
Practice Address - City:INKSTER
Practice Address - State:MI
Practice Address - Zip Code:48141-3069
Practice Address - Country:US
Practice Address - Phone:734-931-6164
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care