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General NPI Number Information
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NPI Number | 1811039670
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Entity Type | Organization
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Legal Business Name | INTEGRATED HOME CARE, INC.
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 12/10/2012
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Provider Practice Location Address
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Address Line | 17550 W 11 MILE RD SUITE A
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City | LATHRUP VILLAGE
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State | MI
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Zip | 48076-4725
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Country | US
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Telephone | 248-424-4881
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Fax | 248-424-4883
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Provider Business Mailing Address
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Address Line | 17550 W 11 MILE RD SUITE A
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City | LATHRUP VILLAGE
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State | MI
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Zip | 48076-4725
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Country | US
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Telephone | 248-424-4881
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Fax | 248-424-4883
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. PAMELA BRODER
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Credential | BBA
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Telephone | 248-424-4881
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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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