Tuckerville.Llc

LBN: Tuckerville.Llc
Tuckerville.Llc is an health care organization with primary practice located at 35230 E Michigan Ave , Wayne MI 48184-3698. The organization recently has 6 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Agencies / Home Health, Agencies / Public Health or Welfare, Agencies / In Home Supportive Care, Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), Managed Care Organizations / Health Maintenance Organization. Agencies / Home Health is the primary health care specialty. Tuckerville.Llc can be contacted via phone (313) 312-5706, or through Tucker, Fartima via phone (313) 303-7423.

Contact Information

Primary practice address
35230 E Michigan Ave Wayne MI 48184-3698
Phone: (313) 312-5706
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Tucker, Fartima LMSW, IMH-E(II)
Phone: (313) 303-7423

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X
Agencies / Home Health 251E00000X E79564 Michigan
Agencies / Public Health or Welfare 251K00000X E79564 Michigan
Agencies / In Home Supportive Care 253Z00000X E79564 Michigan
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X
Managed Care Organizations / Health Maintenance Organization 302R00000X E79564 Michigan

Profile Details

NPI number 1063870293
LBN Legal business name Tuckerville.Llc
DBA Doing business as
Authorized official Tucker, Fartima LMSW, IMH-E(II)
Entity Organization
Organization subpart 1 No
Enumeration date Feb 2nd, 2016
Last updated Mar 24th, 2023 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063870293 NPPES
Michigan MEDICAID 8025368
Michigan Other 1437626454
Michigan Other 1396097457

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