=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922445352
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FAMILY AND FRIENDS HOME HELP CARE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/24/2013
-----------------------------------------------------
Last Update Date | 05/24/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 17712 SUNDERLAND RD
-----------------------------------------------------
City | DETROIT
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48219-4204
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 313-693-4847
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 3303 17712 SUNDERLAND DETROIT, MI 48219
-----------------------------------------------------
City | FARMINGTON HILLS
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48333-3303
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 313-693-4847
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MISS HOLLY ELIZABETH JOHNSON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 313-693-4847
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------