Healthcare Provider Details

I. General information

NPI: 1801128574
Provider Name (Legal Business Name): FAMILY HOME HEALTH CARE SERVICES MI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2010
Last Update Date: 02/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1933 CHURCHILL BLVD
MT PLEASANT MI
48858-9101
US

IV. Provider business mailing address

1933 CHURCHILL BLVD
MT PLEASANT MI
48858-9101
US

V. Phone/Fax

Practice location:
  • Phone: 989-773-5546
  • Fax: 877-447-0113
Mailing address:
  • Phone: 989-773-5546
  • Fax: 877-447-0113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. JASON S LACINA
Title or Position: OWNER
Credential:
Phone: 989-773-5546