MEDICARE: N'GALLA HOME CARE INC.

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	385H00000X	Respite Care	AF630236882	MI

General Provider Information

NPI Number	:	1639369283
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	N'GALLA HOME CARE INC.

Provider Business Mailing Address
First Line	:	1151 HARTLAND DR
Second Line	:
City	:	TROY
State	:	MI
Zip	:	48083-5446
Country	:	US
Telephone Number	:	248-798-7022
Fax Number	:	247-743-0662

Provider Business Practice Location Address
First Line	:	1151 HARTLAND DR
Second Line	:
City	:	TROY
State	:	MI
Zip	:	48083-5446
Country	:	US
Telephone Number	:	248-798-7022
Fax Number	:	247-743-0662

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MS. BINTA MAMBOH NGALLA
Credential	:	GERONTOLOGIST
Telephone Number	:	248-798-7022

Provider Enumeration Date	:	07/30/2007
Last Update Date	:	07/30/2007

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