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Gabriel Wayne Wallace
Personal Care Attendant in Prescott, Michigan
NPI 1932571056

Gabriel Wayne Wallace is a Personal Care Attendant based in Prescott, MI and is specialized in Personal Care Attendant. Gabriel Wayne Wallace practices in Prescott, MI. The NPI Number for Gabriel Wayne Wallace is 1932571056 and holds a License No. 7666037 (Michigan).

The current practice location address for Gabriel Wayne Wallace is 5208 Michiban Ave., Prescott, MI and can be reached out via phone at 989-305-9629 and via fax at 989-873-1225.

Location: 5208 Michiban Ave., Prescott, MI, 48756-4424
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1932571056
Provider Name
Gabriel Wayne Wallace
Credential
Provider Entity Type
Individual
Gender
Male
Address
5208 Michiban Ave., Prescott, MI, 48756-4424
Phone Number
989-305-9629
Fax Number
989-873-1225
Provider Enumeration Date
10/28/2015
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
7666037 05 MI
institution
Provider Business Practice Location Address Details
Address
5208 Michiban Ave.
City
Prescott
State
Michigan
Zip
48756
Phone Number
989-305-9629
Fax Number
989-873-1225
person
Provider Business Mailing Address Details
Address
5208 Michiban Ave.
City
Prescott
State
Michigan
Zip
48756
Phone Number
989-305-9629
Fax Number
989-873-1225
person
Provider's Taxonomy Details 1
Type
Nursing Service Related Providers
Classification
Technician
Speciality
Personal Care Attendant
Taxonomy
3747P1801X
License No.
7666037 (Michigan)
Definition
An individual who provides assistance with eating, bathing, dressing, personal hygiene, activities of daily living as specified in the plan of care. Services which are incidental to the care furnished, or essential to the health and welfare of the individual may also be provided. Personal care providers must meet state defined training and certification standards
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