Healthcare Provider Details

I. General information

NPI: 1932957222
Provider Name (Legal Business Name): HOMETOWN HAPPIER AT HOME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2024
Last Update Date: 05/10/2024
Certification Date: 05/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4171 S OCEANA DR
NEW ERA MI
49446-9781
US

IV. Provider business mailing address

4171 S OCEANA DR
NEW ERA MI
49446-9781
US

V. Phone/Fax

Practice location:
  • Phone: 231-861-6900
  • Fax: 231-861-7177
Mailing address:
  • Phone: 231-861-6900
  • Fax: 231-861-7177

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: REBEKAH LYN DESARMO
Title or Position: VP OF ADMINISTRATION
Credential: PHARM D., MBA
Phone: 231-861-6902