MEDICARE: FINE 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
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1194906776
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FINE HOME HEALTH CARE, LLC.

Provider Business Mailing Address
First Line	:	33060 NORTHWESTERN HWY STE 210
Second Line	:
City	:	WEST BLOOMFIELD
State	:	MI
Zip	:	48322-3695
Country	:	US
Telephone Number	:	248-328-2939
Fax Number	:	248-328-2941

Provider Business Practice Location Address
First Line	:	33060 NORTHWESTERN HWY STE 210
Second Line	:
City	:	WEST BLOOMFIELD
State	:	MI
Zip	:	48322-3695
Country	:	US
Telephone Number	:	248-328-2939
Fax Number	:	248-328-2941

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	JONATHAN GASSO
Credential	:
Telephone Number	:	248-328-2939

Provider Enumeration Date	:	11/24/2007
Last Update Date	:	10/02/2019

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