Healthcare Provider Details

I. General information

NPI: 1215412515
Provider Name (Legal Business Name): CENTRE HRW INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2018
Last Update Date: 10/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23450 ONEIDA ST
OAK PARK MI
48237-2242
US

IV. Provider business mailing address

30700 TELEGRAPH RD STE 1645
BINGHAM FARMS MI
48025-4525
US

V. Phone/Fax

Practice location:
  • Phone: 248-836-7575
  • Fax:
Mailing address:
  • Phone: 248-283-1100
  • Fax:

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 Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: MOHAMED KAZKAZ
Title or Position: OWNER
Credential:
Phone: 248-836-7575