Healthcare Provider Details

I. General information

NPI: 1801667118
Provider Name (Legal Business Name): TIKANA HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2024
Last Update Date: 01/15/2024
Certification Date: 01/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26526 EUREKA DR
WARREN MI
48091-1114
US

IV. Provider business mailing address

26526 EUREKA DR
WARREN MI
48091-1114
US

V. Phone/Fax

Practice location:
  • Phone: 313-695-5897
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MOHAMMAD ALOM
Title or Position: PRESIDENT
Credential:
Phone: 313-695-5897