1225341241 NPI number — HOME CARE SERVICES OF NW OAKLAND COUNTY, LLC

Table of content: (NPI 1225341241)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225341241 NPI number — HOME CARE SERVICES OF NW OAKLAND COUNTY, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOME CARE SERVICES OF NW OAKLAND COUNTY, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
RIGHT AT HOME
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1225341241
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/19/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
903 N MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROYAL OAK
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48067-1839
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-629-1330
Provider Business Mailing Address Fax Number:
248-629-1331

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6803 DIXIE HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLARKSTON
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48346-5101
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
248-707-5010
Provider Business Practice Location Address Fax Number:
248-707-5009
Provider Enumeration Date:
07/19/2010

Additional Information

Authorized Official

Authorized Official Last Name:
WELSH
Authorized Official First Name:
JEFFREY
Authorized Official Middle Name:
A
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
248-629-1330

Provider Taxonomy Codes

  • Taxonomy code: 253Z00000X , with the licence number:  D2866M , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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