Healthcare Provider Details

I. General information

NPI: 1144622846
Provider Name (Legal Business Name): HOME HELPERS COMPANION AGENCY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2014
Last Update Date: 09/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 E MAIN
MARION MI
49665
US

IV. Provider business mailing address

PO BOX 332 208 E MAIN STREET
MARION MI
49665
US

V. Phone/Fax

Practice location:
  • Phone: 231-908-9100
  • Fax:
Mailing address:
  • Phone: 231-908-9100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. KRISTY ELLSWORTH
Title or Position: CEO
Credential:
Phone: 231-908-9100