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General NPI Number Information
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NPI Number | 1811655137
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Entity Type | Organization
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Legal Business Name | IMMANUEL HOME HELP CARE AGENCY LLC
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Dates
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Enumeration Date | 12/03/2021
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Last Update Date | 01/12/2024
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Provider Practice Location Address
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Address Line | 13854 LAKESIDE CIR FL 2
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City | STERLING HEIGHTS
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State | MI
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Zip | 48313-1443
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Country | US
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Telephone | 734-262-2199
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Fax | 313-397-2900
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Provider Business Mailing Address
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Address Line | PO BOX 4
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City | WAYNE
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State | MI
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Zip | 48184-0004
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Country | US
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Telephone | 172-426-2199
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Fax | 313-397-2900
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Authorized Official
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Title or Position | ADMINISTRATOR/MANAGING EMPLOYER
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Name | SHERON SALMAN
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Credential | MPHA, BBA
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Telephone | 734-262-1997
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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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