Healthcare Provider Details

I. General information

NPI: 1588645980
Provider Name (Legal Business Name): SENIOR HOME HEALTH CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/11/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4204 MARTIN RD SUITE E
COMMERCE TOWNSHIP MI
48390-4135
US

IV. Provider business mailing address

4204 MARTIN RD SUITE E
COMMERCE TOWNSHIP MI
48390-4135
US

V. Phone/Fax

Practice location:
  • Phone: 248-363-7575
  • Fax: 248-363-9214
Mailing address:
  • Phone: 248-363-7575
  • Fax: 248-363-9214

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number StateMI

VIII. Authorized Official

Name: MR. THOMAS G HALLER
Title or Position: PRESIDENT
Credential:
Phone: 248-363-7575