Provider Demographics
NPI:1326843715
Name:LAUNDREA WILLIS
Entity type:Organization
Organization Name:LAUNDREA WILLIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAUNDREA
Authorized Official - Middle Name:ELMIRA
Authorized Official - Last Name:WILLLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-707-9889
Mailing Address - Street 1:4032 E OUTER DR
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48234-2921
Mailing Address - Country:US
Mailing Address - Phone:313-707-9889
Mailing Address - Fax:
Practice Address - Street 1:636 E KIRBY ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-4123
Practice Address - Country:US
Practice Address - Phone:313-600-6301
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-18
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health