Healthcare Provider Details

I. General information

NPI: 1932197217
Provider Name (Legal Business Name): PRIMARY CHOICE HOME CARE OF MICHIGAN, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2005
Last Update Date: 02/03/2020
Certification Date: 02/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32985 HAMILTON CT SUITE 216
FARMINGTON HILLS MI
48334-3317
US

IV. Provider business mailing address

32985 HAMILTON CT SUITE 216
FARMINGTON HILLS MI
48334-3317
US

V. Phone/Fax

Practice location:
  • Phone: 248-473-5400
  • Fax: 248-473-3926
Mailing address:
  • Phone: 248-473-5400
  • Fax: 248-473-3926

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberB46-28F
License Number StateMI

VIII. Authorized Official

Name: MRS. MELANIE T STREBEL
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 248-473-5400