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General NPI Number Information
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NPI Number | 1164645461
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Entity Type | Organization
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Legal Business Name | LAKE CITY HOME HEALTH CARE, INC.
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 11/10/2008
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Provider Practice Location Address
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Address Line | 5880 CANTON CENTER RD SUITE 410
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City | CANTON
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State | MI
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Zip | 48187-2686
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Country | US
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Telephone | 734-644-3111
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Fax | 734-727-1579
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Provider Business Mailing Address
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Address Line | 5880 N CANTON CENTER RD SUITE 410
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City | CANTON
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State | MI
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Zip | 48187-2686
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Country | US
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Telephone | 734-377-2094
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Fax | 734-254-0004
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Authorized Official
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Title or Position | PRESIDENT
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Name | SYED T AKHTAR
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Credential |
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Telephone | 734-377-2094
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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