1952762791 NPI number — ASSISTANCE 1 HOME CARE SERVICES, LTD.

Table of content: (NPI 1952762791)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952762791 NPI number — ASSISTANCE 1 HOME CARE SERVICES, LTD.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ASSISTANCE 1 HOME CARE SERVICES, LTD.
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:
NONE
Provider Other Organization Name Type Code:
4
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:
1952762791
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/08/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
26140 W 12 MILE RD
Provider Second Line Business Mailing Address:
114
Provider Business Mailing Address City Name:
SOUTHFIELD
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48034-1762
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
313-293-2944
Provider Business Mailing Address Fax Number:
855-727-7552

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
26140 W 12 MILE RD
Provider Second Line Business Practice Location Address:
114
Provider Business Practice Location Address City Name:
SOUTHFIELD
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48034-1762
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
313-293-2944
Provider Business Practice Location Address Fax Number:
855-727-7552
Provider Enumeration Date:
03/08/2016

Additional Information

Authorized Official

Authorized Official Last Name:
BROWN
Authorized Official First Name:
REGINA
Authorized Official Middle Name:
LYNNETTE
Authorized Official Title or Position:
CEO PRESIDENT
Authorized Official Telephone Number:
313-293-2944

Provider Taxonomy Codes

  • Taxonomy code: 253Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 7249277 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com