Healthcare Provider Details

I. General information

NPI: 1447522768
Provider Name (Legal Business Name): REGIONAL HOME CARE OF MICHIGAN INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2012
Last Update Date: 02/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

69045 M 62 STE E
EDWARDSBURG MI
49112-9152
US

IV. Provider business mailing address

PO BOX 128
ELKHART IN
46515-0128
US

V. Phone/Fax

Practice location:
  • Phone: 574-295-1111
  • 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

VIII. Authorized Official

Name: PAMELA J FAHLBECK
Title or Position: PRESIDENT/CEO
Credential: RN
Phone: 574-295-1111