Healthcare Provider Details

I. General information

NPI: 1316210305
Provider Name (Legal Business Name): 247 HOME HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2012
Last Update Date: 08/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12345 TELEGRAPH RD, SUITE 111
TAYLOR MI
48180
US

IV. Provider business mailing address

12345 TELEGRAPH ROAD, SUITE 111
TAYLOR MI
48180
US

V. Phone/Fax

Practice location:
  • Phone: 734-731-0786
  • Fax: 866-882-7881
Mailing address:
  • Phone: 734-731-0786
  • Fax: 866-882-7881

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: AMER LATIF
Title or Position: PRESIDENT
Credential:
Phone: 734-731-0786