Healthcare Provider Details

I. General information

NPI: 1255923512
Provider Name (Legal Business Name): BIG HEARTED HOME HEALTH CARE AGENCY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2021
Last Update Date: 02/08/2021
Certification Date: 02/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 N WASHINGTON ST # 708
YPSILANTI MI
48197-2617
US

IV. Provider business mailing address

13 N WASHINGTON ST # 708
YPSILANTI MI
48197-2617
US

V. Phone/Fax

Practice location:
  • Phone: 833-244-4221
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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

VIII. Authorized Official

Name: SHADAE JONES ROWE
Title or Position: MANAGEMENT
Credential:
Phone: 833-244-4221