MEDICARE: CELEBRATION HOME 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	:	1669606778
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CELEBRATION HOME CARE, LLC

Provider Business Mailing Address
First Line	:	37899 W 12 MILE RD
Second Line	:	SUITE 220
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48331-3048
Country	:	US
Telephone Number	:	248-994-0280
Fax Number	:

Provider Business Practice Location Address
First Line	:	37899 W 12 MILE RD
Second Line	:	SUITE 220
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48331-3048
Country	:	US
Telephone Number	:	248-994-0280
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. CHERIE CHARTIER WHITING
Credential	:	PHD
Telephone Number	:	248-994-0280

Provider Enumeration Date	:	05/05/2009
Last Update Date	:	05/05/2009

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