MEDICARE: LUPINE HOME 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1497691927
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LUPINE HOME CARE LLC

Provider Business Mailing Address
First Line	:	4042 WEBBER ST
Second Line	:
City	:	SAGINAW
State	:	MI
Zip	:	48601-4145
Country	:	US
Telephone Number	:	628-215-5418
Fax Number	:

Provider Business Practice Location Address
First Line	:	4042 WEBBER ST
Second Line	:
City	:	SAGINAW
State	:	MI
Zip	:	48601-4145
Country	:	US
Telephone Number	:	628-215-5418
Fax Number	:

Authorized Official
Title or Position	:	OWNER/AGENT
Name	:	KAYLEE B KEENAN
Credential	:	KEENAN
Telephone Number	:	628-215-5418

Provider Enumeration Date	:	04/27/2026
Last Update Date	:	04/27/2026

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Directions to “LUPINE HOME CARE LLC ” Practice Location

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