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General NPI Number Information
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NPI Number | 1528223666
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Entity Type | Organization
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Legal Business Name | GRAND HOME CARE, LLC
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Dates
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Enumeration Date | 07/28/2008
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Last Update Date | 07/28/2008
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Provider Practice Location Address
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Address Line | 8033 E 10 MILE RD SUITE 114
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City | CENTER LINE
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State | MI
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Zip | 48015-1427
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Country | US
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Telephone | 586-707-1446
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Fax | 586-756-6933
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Provider Business Mailing Address
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Address Line | 8033 E 10 MILE RD SUITE 114
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City | CENTER LINE
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State | MI
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Zip | 48015-1427
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Country | US
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Telephone | 586-707-1446
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Fax | 586-756-6933
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Authorized Official
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Title or Position | CEO/ADMINISTRATOR
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Name | MS. SUZANNE MARIE RUNYON
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Credential | R.N.
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Telephone | 586-707-1446
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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 | MI
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