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General NPI Number Information
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NPI Number | 1164995312
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Entity Type | Organization
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Legal Business Name | HOME WITH A HEART COMMUNITY DEVELOPMENT CORPORATION
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Dates
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Enumeration Date | 01/09/2019
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Last Update Date | 01/09/2019
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Provider Practice Location Address
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Address Line | 18164 MAINE ST
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City | DETROIT
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State | MI
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Zip | 48234-1477
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Country | US
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Telephone | 586-424-1378
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Fax |
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Provider Business Mailing Address
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Address Line | 20141 HARNED ST
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City | DETROIT
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State | MI
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Zip | 48234-1514
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Country | US
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Telephone | 586-424-1378
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. LORINE ROSS
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Credential |
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Telephone | 586-424-1378
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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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