Healthcare Provider Details

I. General information

NPI: 1942408083
Provider Name (Legal Business Name): BRIDGE HOME HEALTH CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2007
Last Update Date: 11/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29200 VASSAR ST SUITE 540
LIVONIA MI
48152-2193
US

IV. Provider business mailing address

29200 VASSAR ST SUITE 540
LIVONIA MI
48152-2193
US

V. Phone/Fax

Practice location:
  • Phone: 248-888-9412
  • Fax: 248-888-9409
Mailing address:
  • Phone: 248-888-9412
  • Fax: 248-888-9409

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: MR. NASIR M KHAN
Title or Position: PRESIDENT/ADMINISTRATOR
Credential:
Phone: 248-888-9412