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General NPI Number Information
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NPI Number | 1104162833
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Entity Type | Organization
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Legal Business Name | HOMESTEAD HOME HEALTH CARE, LLC
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Dates
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Enumeration Date | 12/28/2012
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Last Update Date | 01/09/2013
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Provider Practice Location Address
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Address Line | 32001 CHERRY HILL RD
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City | WESTLAND
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State | MI
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Zip | 48186-7902
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Country | US
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Telephone | 734-762-8757
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Fax | 734-762-8945
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Provider Business Mailing Address
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Address Line | 21800 HAGGERTY ROAD SUITE 205
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City | NORTHVILLE
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State | MI
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Zip | 48167
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Country | US
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Telephone | 248-735-1020
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Fax | 248-735-1010
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Authorized Official
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Title or Position | OWNER
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Name | MR. CARL SIMCOX
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Credential |
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Telephone | 248-735-1020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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