Healthcare Provider Details

I. General information

NPI: 1629217351
Provider Name (Legal Business Name): HOME VISITING GROUP,INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2009
Last Update Date: 08/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21700 GREENFIELD RD STE 281
OAK PARK MI
48237-2581
US

IV. Provider business mailing address

21700 GREENFIELD RD STE 281
OAK PARK MI
48237-2581
US

V. Phone/Fax

Practice location:
  • Phone: 519-997-3900
  • Fax:
Mailing address:
  • Phone: 519-997-3900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number State

VIII. Authorized Official

Name: MR. FARID AHMAD
Title or Position: CEO
Credential:
Phone: 519-997-3900