MEDICARE: MOBILITY PLUS HOME HEALTH CARE, 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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	OE936	OTHER	MI	BLUE CROSS BLUE SHIELD MI
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619960291
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOBILITY PLUS HOME HEALTH CARE, INC.

Provider Business Mailing Address
First Line	:	5701 CHICAGO RD
Second Line	:	SUITE D
City	:	WARREN
State	:	MI
Zip	:	48092-5033
Country	:	US
Telephone Number	:	586-978-9850
Fax Number	:	586-978-9851

Provider Business Practice Location Address
First Line	:	5701 CHICAGO RD
Second Line	:	SUITE D
City	:	WARREN
State	:	MI
Zip	:	48092-5033
Country	:	US
Telephone Number	:	586-978-9850
Fax Number	:	586-978-9851

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. SANJAY RATTAN
Credential	:	RPT
Telephone Number	:	586-978-9850

Provider Enumeration Date	:	08/29/2005
Last Update Date	:	08/22/2020

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