Healthcare Provider Details

I. General information

NPI: 1912186941
Provider Name (Legal Business Name): FIRST HERITAGE HEALTH CARE SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2007
Last Update Date: 10/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29430 MARIMOOR DR
SOUTHFIELD MI
48076-5237
US

IV. Provider business mailing address

29430 MARIMOOR DR
SOUTHFIELD MI
48076-5237
US

V. Phone/Fax

Practice location:
  • Phone: 248-346-0336
  • Fax: 248-968-9715
Mailing address:
  • Phone: 248-346-0336
  • Fax: 248-968-9715

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number251E00000X
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number251J00000X
License Number StateMI

VIII. Authorized Official

Name: MRS. IRENE O OSHIYOYE
Title or Position: PRESIDENT
Credential: RN, MSN,MBA
Phone: 248-346-0336