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General NPI Number Information
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NPI Number | 1386885176
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Entity Type | Organization
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Legal Business Name | SHORELINE HOME HEALTH CARE, LLC
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Dates
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Enumeration Date | 03/09/2009
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Last Update Date | 03/09/2009
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Provider Practice Location Address
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Address Line | 18600 W 10 MILE RD STE 211
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City | SOUTHFIELD
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State | MI
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Zip | 48075-2645
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Country | US
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Telephone | 248-552-6200
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Fax | 248-552-6222
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Provider Business Mailing Address
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Address Line | 18600 W 10 MILE RD STE 211
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City | SOUTHFIELD
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State | MI
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Zip | 48075-2645
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Country | US
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Telephone | 248-552-6200
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Fax | 248-552-6222
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. AUGUSTO J DAYCO
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Credential |
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Telephone | 248-552-6200
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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 | E34322
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License Number State | MI
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