1528227329 NPI number — HEALING HOME HEALTHCARE LLC

Table of content: (NPI 1528227329)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528227329 NPI number — HEALING HOME HEALTHCARE LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEALING HOME HEALTHCARE 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:
Provider Other Organization Name Type Code:
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:
1528227329
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/11/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
30600 NORTHWESTERN HWY STE 245A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FARMINGTON HILLS
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48334-3161
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-212-0818
Provider Business Mailing Address Fax Number:
248-479-8126

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
24755 5 MILE RD
Provider Second Line Business Practice Location Address:
SUITE# 205
Provider Business Practice Location Address City Name:
REDFORD
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48239-3665
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
313-535-7371
Provider Business Practice Location Address Fax Number:
313-535-7391
Provider Enumeration Date:
06/06/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LAING
Authorized Official First Name:
JASON
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
248-212-0818

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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