MEDICARE: ONYX HOME HEALTH CARE, 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1356410328
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ONYX HOME HEALTH CARE, LLC

Provider Business Mailing Address
First Line	:	16633 LIVERNOIS AVE
Second Line	:	SUITE 2
City	:	DETROIT
State	:	MI
Zip	:	48221-3098
Country	:	US
Telephone Number	:	313-864-5060
Fax Number	:	313-864-5090

Provider Business Practice Location Address
First Line	:	16633 LIVERNOIS AVE
Second Line	:	SUITE 2
City	:	DETROIT
State	:	MI
Zip	:	48221-3098
Country	:	US
Telephone Number	:	313-864-5060
Fax Number	:	313-864-5090

Authorized Official
Title or Position	:	OWNER
Name	:	JASON DIXON
Credential	:
Telephone Number	:	313-864-5060

Provider Enumeration Date	:	11/06/2006
Last Update Date	:	09/16/2009

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