MEDICARE: SINCERE HOME HEALTHCARE SERVICES, LLC

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	313M00000X	Nursing Facility/Intermediate Care Facility	4704202809	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	9999999	OTHER	MI	MIHP

General Provider Information

NPI Number	:	1104125269
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SINCERE HOME HEALTHCARE SERVICES, LLC

Provider Business Mailing Address
First Line	:	19785 W 12 MILE RD
Second Line	:	SUITE 203
City	:	SOUTHFIELD
State	:	MI
Zip	:	48076-2584
Country	:	US
Telephone Number	:	248-730-5005
Fax Number	:

Provider Business Practice Location Address
First Line	:	19785 W 12 MILE RD
Second Line	:	SUITE 203
City	:	SOUTHFIELD
State	:	MI
Zip	:	48076-2584
Country	:	US
Telephone Number	:	248-730-5005
Fax Number	:

Authorized Official
Title or Position	:	OWNER & OPERATOR
Name	:	MRS. HELEN SMITH
Credential	:	R.N.
Telephone Number	:	248-730-5005

Provider Enumeration Date	:	03/15/2011
Last Update Date	:	03/15/2011

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