MEDICARE: FAMILY CONNECT HOME HEALTH CARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency		MI

General Provider Information

NPI Number	:	1053587378
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY CONNECT HOME HEALTH CARE

Provider Business Mailing Address
First Line	:	1027 E GRAND BLVD
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48207-1926
Country	:	US
Telephone Number	:	313-304-5330
Fax Number	:

Provider Business Practice Location Address
First Line	:	1027 E GRAND BLVD
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48207-1926
Country	:	US
Telephone Number	:	313-304-5330
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KAREN LOTHERY
Credential	:
Telephone Number	:	313-304-5330

Provider Enumeration Date	:	05/06/2008
Last Update Date	:	05/06/2008

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Directions to “FAMILY CONNECT HOME HEALTH CARE ” Practice Location

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