Provider Demographics
NPI:1679328207
Name:HOME SUPPORT SERVICES OF MICHIGAN LLC.
Entity type:Organization
Organization Name:HOME SUPPORT SERVICES OF MICHIGAN LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:TRACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-242-2233
Mailing Address - Street 1:16712 HARLOW ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48235-3429
Mailing Address - Country:US
Mailing Address - Phone:248-242-2233
Mailing Address - Fax:
Practice Address - Street 1:16712 HARLOW ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48235-3429
Practice Address - Country:US
Practice Address - Phone:248-242-2233
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-18
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care