Provider Demographics
NPI:1699570408
Name:LINDSEY, LATIA SADE
Entity type:Individual
Prefix:
First Name:LATIA
Middle Name:SADE
Last Name:LINDSEY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14224 GRANDVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48223-2900
Mailing Address - Country:US
Mailing Address - Phone:313-718-0132
Mailing Address - Fax:
Practice Address - Street 1:14224 GRANDVILLE AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48223-2900
Practice Address - Country:US
Practice Address - Phone:313-718-0132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-17
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide