MEDICARE: CLOSE 2 HOME

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	:	1831504547
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLOSE 2 HOME

Provider Business Mailing Address
First Line	:	15117 QUINCY
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48238
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	15117 QUINCY ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48238-2165
Country	:	US
Telephone Number	:	947-282-3139
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	STARR BILLUPS
Credential	:
Telephone Number	:	947-282-3139

Provider Enumeration Date	:	06/23/2014
Last Update Date	:	06/23/2014

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Directions to “CLOSE 2 HOME ” Practice Location

Language	Start Address	Practice Location

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