Healthcare Provider Details

I. General information

NPI: 1881308849
Provider Name (Legal Business Name): ORTIS HOME HEALTH CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2023
Last Update Date: 01/12/2023
Certification Date: 01/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13854 LAKESIDE CIR STE 263
STERLING HEIGHTS MI
48313-1443
US

IV. Provider business mailing address

13854 LAKESIDE CIR STE 263
STERLING HEIGHTS MI
48313-1443
US

V. Phone/Fax

Practice location:
  • Phone: 833-678-4743
  • Fax: 833-678-4743
Mailing address:
  • Phone: 833-678-4743
  • Fax: 833-678-4743

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
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: EHTESHAM E ANSARI
Title or Position: ADMINISTRATOR
Credential:
Phone: 586-506-1996