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General NPI Number Information
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NPI Number | 1649405374
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Entity Type | Organization
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Legal Business Name | INTERDEPENDENCE HOME HEALTH CARE
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Dates
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Enumeration Date | 05/26/2009
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Last Update Date | 05/26/2009
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Provider Practice Location Address
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Address Line | 780 W LAKE LANSING RD STE 780
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City | EAST LANSING
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State | MI
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Zip | 48823-8474
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Country | US
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Telephone | 517-332-1903
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Fax | 517-332-1992
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Provider Business Mailing Address
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Address Line | 780 W LAKE LANSING RD STE 780
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City | EAST LANSING
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State | MI
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Zip | 48823-8474
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Country | US
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Telephone | 517-332-1903
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Fax | 517-332-1992
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Authorized Official
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Title or Position | PRESIDENT
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Name | JEAN ZAJDEL
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Credential |
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Telephone | 517-332-1903
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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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