MEDICARE: LIFE ESSENTIALS HOME HEALTH CARE, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	4704231527	MI

General Provider Information

NPI Number	:	1043492150
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIFE ESSENTIALS HOME HEALTH CARE, INC

Provider Business Mailing Address
First Line	:	524 FOX HILLS DR S
Second Line	:
City	:	BLOOMFIELD HILLS
State	:	MI
Zip	:	48304-1316
Country	:	US
Telephone Number	:	248-335-0827
Fax Number	:

Provider Business Practice Location Address
First Line	:	615 GRISWOLD ST STE 1712
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48226-3990
Country	:	US
Telephone Number	:	313-962-2996
Fax Number	:	313-962-2997

Authorized Official
Title or Position	:	OWNER/DIRECTOR OF NURSING
Name	:	MS. ANGELA KATRINA HOWARD
Credential	:	RN
Telephone Number	:	313-999-4201

Provider Enumeration Date	:	11/30/2007
Last Update Date	:	11/30/2007

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