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General NPI Number Information
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NPI Number | 1922451897
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Entity Type | Organization
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Legal Business Name | MICHIGAN HOME CARE AGENCY
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Dates
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Enumeration Date | 07/15/2016
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Last Update Date | 05/20/2020
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Provider Practice Location Address
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Address Line | 1852 COMMONWEALTH ROAD
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City | SAINT JOSEPH TOWNSHIP CHRTR
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State | MI
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Zip | 49085
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Country | US
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Telephone | 269-759-3048
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Fax | 269-222-2689
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Provider Business Mailing Address
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Address Line | 1852 COMMONWEALTH ROAD
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City | SAINT JOSEPH TOWNSHIP CHRTR
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State | MI
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Zip | 49085
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Country | US
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Telephone | 269-759-3048
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Fax | 269-222-2689
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. MELANIE J GOFF
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Credential | MSW
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Telephone | 269-759-3084
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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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