Healthcare Provider Details

I. General information

NPI: 1316453350
Provider Name (Legal Business Name): OPEX PROFESSIONAL HOME CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2017
Last Update Date: 12/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 GREENFIELD RD STE 300
DEARBORN MI
48120-1800
US

IV. Provider business mailing address

3200 GREENFIELD RD STE 300
DEARBORN MI
48120-1800
US

V. Phone/Fax

Practice location:
  • Phone: 248-506-9098
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: PHEBE SIMMONS
Title or Position: TREASURER
Credential:
Phone: 209-815-8468