Healthcare Provider Details

I. General information

NPI: 1871308965
Provider Name (Legal Business Name): MGM HOME CARE & STAFFING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2025
Last Update Date: 02/07/2025
Certification Date: 02/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 GREENWOOD AVE
JACKSON MI
49203-3113
US

IV. Provider business mailing address

470 COMMONS BLVD APT C
JACKSON MI
49203-1152
US

V. Phone/Fax

Practice location:
  • Phone: 517-769-4789
  • Fax:
Mailing address:
  • Phone: 517-769-4789
  • 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: SHARRA MORGAN
Title or Position: OWNER/MANAGING EMPLOYEE
Credential:
Phone: 517-769-4789