MEDICARE: CLASSIC HOME CARE-LIVINGSTON, 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

General Provider Information

NPI Number	:	1245420504
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLASSIC HOME CARE-LIVINGSTON, INC.

Provider Business Mailing Address
First Line	:	135 W NORTH ST
Second Line	:	SUITE 4
City	:	BRIGHTON
State	:	MI
Zip	:	48116-1572
Country	:	US
Telephone Number	:	810-229-2271
Fax Number	:	810-229-7277

Provider Business Practice Location Address
First Line	:	135 W NORTH ST
Second Line	:	SUITE 4
City	:	BRIGHTON
State	:	MI
Zip	:	48116-1572
Country	:	US
Telephone Number	:	810-229-2271
Fax Number	:	810-229-7277

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	MS. NEELAM GUGLANI
Credential	:
Telephone Number	:	810-229-2271

Provider Enumeration Date	:	08/01/2007
Last Update Date	:	10/27/2008

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