Healthcare Provider Details

I. General information

NPI: 1649225244
Provider Name (Legal Business Name): RESIDENTIAL HOME CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 02/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11477 EAST 12 MILE ROAD
WARREN MI
48093-2678
US

IV. Provider business mailing address

11477 EAST 12 MILE ROAD
WARREN MI
48093-2678
US

V. Phone/Fax

Practice location:
  • Phone: 586-751-0200
  • Fax: 586-751-0414
Mailing address:
  • Phone: 586-751-0200
  • Fax: 586-751-0414

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: E G METROPOULOS
Title or Position: PRESIDENT
Credential: MD
Phone: 586-751-0200