MEDICARE: RELIANT HOME CARE 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	:	1396412268
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RELIANT HOME CARE SERVICES LLC

Provider Business Mailing Address
First Line	:	PO BOX 1377
Second Line	:
City	:	TROY
State	:	MI
Zip	:	48099-1377
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	43417 INTERLAKEN DR
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48313-2371
Country	:	US
Telephone Number	:	586-360-9819
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	NICHOLAS SELCA
Credential	:
Telephone Number	:	586-360-9819

Provider Enumeration Date	:	08/26/2021
Last Update Date	:	08/26/2021

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