Provider Demographics
NPI:1366727711
Name:FAMILY'S R US
Entity type:Organization
Organization Name:FAMILY'S R US
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARYN
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:CLAYTON
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:313-728-3736
Mailing Address - Street 1:2785 E GRAND BLVD
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48211-2003
Mailing Address - Country:US
Mailing Address - Phone:313-623-1555
Mailing Address - Fax:313-872-7832
Practice Address - Street 1:2785 E GRAND BLVD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48211-2003
Practice Address - Country:US
Practice Address - Phone:313-623-1555
Practice Address - Fax:313-872-7832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-17
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704271302253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care