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NPI Code Detail

MEDICARE: FIVE STAR HOME HEALTH CARE, LLC

MEDICARE: FIVE STAR HOME HEALTH CARE, LLC
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
1251E00000XHome Health Agency

General Provider Information

NPI Number : 1124203237
Entity Type Code : Organization
Provider Name (Legal Business Name) : FIVE STAR HOME HEALTH CARE, LLC
Provider Business Mailing Address
First Line : 13530 MICHIGAN AVE
Second Line : STE 328
City : DEARBORN
State : MI
Zip : 48126-3574
Country : US
Telephone Number : 313-846-9500
Fax Number : 313-846-0650
Provider Business Practice Location Address
First Line : 13530 MICHIGAN AVE
Second Line : STE 328
City : DEARBORN
State : MI
Zip : 48126-3574
Country : US
Telephone Number : 313-846-9500
Fax Number : 313-846-0650
Authorized Official
Title or Position : CLINICAL DIRECTOR & ADMINISTRATOR
Name : MRS. KAY ELDER
Credential : RN
Telephone Number : 313-846-9500
Provider Enumeration Date : 01/08/2008
Last Update Date : 10/06/2009

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Directions to “FIVE STAR HOME HEALTH CARE, LLC ” Practice Location

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