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General NPI Number Information
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NPI Number | 1215636154
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Entity Type | Organization
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Legal Business Name | MINA HOME CARE AGENCY, INC
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Dates
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Enumeration Date | 02/28/2023
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Last Update Date | 02/28/2023
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Provider Practice Location Address
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Address Line | 3243 RICE CT
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City | LANSING
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State | MI
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Zip | 48911-1544
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Country | US
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Telephone | 260-443-9698
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Fax |
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Provider Business Mailing Address
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Address Line | 2523 SHERBORNE BLVD
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City | FORT WAYNE
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State | IN
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Zip | 46805-3054
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NA HU
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Credential |
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Telephone | 260-443-9698
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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