MEDICARE: HANNAH'S HELPER HOMECARE AGENCY 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
2	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1700028859
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HANNAH'S HELPER HOMECARE AGENCY LLC

Provider Business Mailing Address
First Line	:	535 GRISWOLD ST STE 239
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48226-3604
Country	:	US
Telephone Number	:	313-740-5685
Fax Number	:

Provider Business Practice Location Address
First Line	:	535 GRISWOLD ST STE 239
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48226-3604
Country	:	US
Telephone Number	:	313-740-5685
Fax Number	:

Authorized Official
Title or Position	:	OWNER/ EXECUTIVE DIRECTOR
Name	:	MS. MS. CHARISMA N. FIKES
Credential	:
Telephone Number	:	313-740-5685

Provider Enumeration Date	:	04/02/2009
Last Update Date	:	04/16/2009

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