LATESA RENAE THOMAS (NPI# 1639636855) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1639636855 |
Entity Type | Individual |
Full Name | LATESA RENAE THOMAS |
Other Name | LATESA RENAE ENGRAM |
Credential | C.N.A |
Practice Address |
11611 Grayton St Detroit MI 48224-1643 |
Practice Telephone | 3135564769 |
Practice Fax Number | 3134738192 |
Mailing Telephone | 3135564769 |
Mailing Fax Number | 3134738192 |
Enumeration Date | 2019-02-24 |
Last Update Date | 2019-08-26 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 372600000X | Adult Companion | 230109450998 | MI | Nursing Service Related Providers |
Address | Telephone Number | Fax Number |
---|---|---|
7762 Rosemont Ave, Detroit, MI 482285426 | 3136586938 |
Street Address |
11611 GRAYTON ST |
City | DETROIT |
State | MI |
Zip Code | 48224-1643 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386101574 | Yamisha Jackson | Adult Companion | 11611 Grayton St, Detroit, MI 48224-1643 | 2019-02-25 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1508403767 | Renia Scott | Licensed Practical Nurse | 5211 Berkshire St, Detroit, MI 48224 | 2019-12-06 |
1063928612 | Edith Neely-harris | Registered Nurse | 1203 Courville Street, Detroit, MI 48224 | 2017-12-19 |
1043767585 | Annette Jackson | Counselor | 10666 Duprey St, Detroit, MI 48224 | 2016-09-01 |
1164977807 | Dehvin White-peck | Technician, Other | 4529 Harvard Rd, Detroit, MI 48224 | 2016-08-23 |
1992153704 | Andrea Henderson | Licensed Practical Nurse | 9131 Bradford, Detroit, MI 48224 | 2016-06-02 |
1467807578 | Venus Staffing LLC | Nursing Care | 5601 Devonshire Rd, Detroit, MI 48224 | 2016-04-26 |
1558795625 | Rafia El-alayli | Internal Medicine | 9901 Whittier Ave, Detroit, MI 48224 | 2013-08-26 |
1831334259 | House of Hearts Ministry, Inc. | Voluntary or Charitable | 11151 Worden, Detroit, MI 48224 | 2008-12-15 |
1992994636 | Lilian Lai Md PC | Clinic/Center | 15850 E Warren Ave, Detroit, MI 48224 | 2007-10-18 |
1184845844 | Tymon C Totte | Dentist | 17700 Mack Ave, Great Expressions Dental Centers, Gross Pointe, MI 48224 | 2007-05-01 |
Find all providers in zip 48224 |
Taxonomy Code | 372600000X |
Grouping | Nursing Service Related Providers |
Classification | Adult Companion |
An individual who provides supervision, socialization, and non-medical care to a functionally impaired adult. Companions may assist or supervise the individual with such tasks as meal preparation, laundry and shopping, but do not perform these activities as discrete services. These services are provided in accordance with a therapeutic goal in the plan of care. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407412638 | Geisha Shanee Burton | Adult Companion | 8160 E Lantz St, Detroit, MI 48234-3303 | 2019-05-13 |
1205323086 | Theresa A Akin | Adult Companion | 20485 Goddard St Apt 102, Detroit, MI 48234-1354 | 2018-04-17 |
1114442084 | Rhonda Lewis | Adult Companion | 18603 Mendota St, Detroit, MI 48221-1911 | 2017-08-11 |
1275062002 | Iyeshia Galloway | Adult Companion | 5075 Farmbrook St, Detroit, MI 48224-1377 | 2017-06-06 |
1386095073 | Tabatha M Scott | Adult Companion | 2823 County Road 1247, Detroit, TX 75436-5113 | 2016-06-24 |
1790157774 | Shakail Bronta Hill | Adult Companion | 7729 Clayburn, Detroit, MI 48228 | 2015-10-29 |
1972820074 | Ardretta Carly Taylor | Adult Companion | 7750 Montrose St, Detroit, MI 48228-3609 | 2010-04-28 |
1386101574 | Yamisha Jackson | Adult Companion | 11611 Grayton St, Detroit, MI 48224-1643 | 2019-02-25 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1275131112 | Kimberly Ann Walker | Adult Companion | 452 Bay St, Pontiac, MI 48342-1912 | 2020-10-13 |
1093346462 | Easy Living Assistance | Adult Companion | 41000 Woodward Ave Suite E 350, Bloomfield Twp, MI 48304 | 2020-02-04 |
1346883618 | Barbara Rodriguez | Adult Companion | 2295 N Winn Rd, Mount Pleasant, MI 48858-9736 | 2019-10-19 |
1407415730 | Monesha Maria Moore | Adult Companion | 29555 Laurel Woods Dr Apt 205, Southfield, MI 48034-4664 | 2019-06-11 |
1912470907 | Austyn Desean Hollingshed | Adult Companion | 485 Hustler St, Gwinn, MI 49841-2902 | 2019-01-02 |
1437626256 | Carrie Lynn Dextrom | Adult Companion | 9200 W Walker Rd, Manton, MI 49663-9315 | 2018-10-30 |
1356876213 | Richelle L Daniels | Adult Companion | 26740 Joy Rd, D11, Redford, MI 48239-1970 | 2017-04-27 |
1184095713 | David Farzalo | Adult Companion | 3500 Jennings Rd, Whitmore Lake, MI 48189-9506 | 2015-10-08 |
1437526639 | Kurt Kazanowski | Adult Companion | 296 S Main St Ste 203, Plymouth, MI 48170-4256 | 2015-08-24 |
1043692064 | Lourdes Salinas | Adult Companion | 1624 Detroit Ave, Lincoln Park, MI 48146-3217 | 2015-06-25 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.