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General NPI Number Information
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NPI Number | 1962944710
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Entity Type | Organization
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Legal Business Name | IRWIN'S HOMECARE, LLC
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Dates
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Enumeration Date | 11/10/2016
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Last Update Date | 11/10/2016
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Provider Practice Location Address
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Address Line | 125 IRWIN ST
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City | BROOKLYN
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State | MI
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Zip | 49230-9271
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Country | US
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Telephone | 517-481-2177
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Fax | 517-481-4461
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Provider Business Mailing Address
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Address Line | 125 IRWIN ST
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City | BROOKLYN
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State | MI
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Zip | 49230-9271
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Country | US
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Telephone | 517-481-2177
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Fax | 517-481-4461
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Authorized Official
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Title or Position | OWNER
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Name | MR. LARRY DEAN IRWIN JR.
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Credential | RRT
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Telephone | 517-481-2177
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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