MEDICARE: HALSTEAD NURSING SERVICES 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	:	1386243376
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HALSTEAD NURSING SERVICES LLC

Provider Business Mailing Address
First Line	:	15226 S TELEGRAPH RD
Second Line	:
City	:	MONROE
State	:	MI
Zip	:	48161-4064
Country	:	US
Telephone Number	:	419-344-8919
Fax Number	:

Provider Business Practice Location Address
First Line	:	518 WESTBROOK
Second Line	:
City	:	WHITMORE LAKE
State	:	MI
Zip	:	48189-8212
Country	:	US
Telephone Number	:	418-344-8919
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF NURSING
Name	:	MRS. MEGHANNE DENISE DECANT
Credential	:	RN
Telephone Number	:	419-344-8919

Provider Enumeration Date	:	10/20/2020
Last Update Date	:	10/20/2020

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