1992984660 NPI number — NATALIS HOME HEALTH CARE, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992984660 NPI number — NATALIS HOME HEALTH CARE, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NATALIS HOME HEALTH CARE, 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:
1992984660
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/07/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 44805
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DETROIT
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48244-0805
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
313-964-2648
Provider Business Mailing Address Fax Number:
186-646-8958

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
155 W. CONGRESS
Provider Second Line Business Practice Location Address:
SUITE 306
Provider Business Practice Location Address City Name:
DETROIT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48226-3272
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
313-964-2648
Provider Business Practice Location Address Fax Number:
866-468-9584
Provider Enumeration Date:
10/30/2007

Additional Information

Authorized Official

Authorized Official Last Name:
WILLIAMS
Authorized Official First Name:
TASHA
Authorized Official Middle Name:
LYNTRICE
Authorized Official Title or Position:
DIRECTOR OF MARKETING & OPERATIONS
Authorized Official Telephone Number:
313-964-2648

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)





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