Healthcare Provider Details
I. General information
NPI: 1558491829
Provider Name (Legal Business Name): VNA CARING HOME SUPPORT, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/06/2007
Last Update Date: 06/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
959 W HURON ST
WATERFORD MI
48328-3727
US
IV. Provider business mailing address
959 W HURON ST
WATERFORD MI
48328-3727
US
V. Phone/Fax
- Phone: 248-683-1770
- Fax: 248-683-1774
- Phone: 248-683-1770
- Fax: 248-683-1774
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | MI |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251F00000X |
| Taxonomy | Home Infusion Agency |
| License Number | |
| License Number State | MI |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251K00000X |
| Taxonomy | Public Health or Welfare Agency |
| License Number | |
| License Number State | MI |
VIII. Authorized Official
Name:
DONNA
MARIE
FISHMAN
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: MSN
Phone: 248-683-1770