MEDICARE: MAXICARE HOME HEALTH AGENCY, 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	N/A	MI
2	251E00000X	Home Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0E928	OTHER	MI	BCBS

General Provider Information

NPI Number	:	1952305906
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAXICARE HOME HEALTH AGENCY, INC

Provider Business Mailing Address
First Line	:	28909 UTICA ROAD
Second Line	:
City	:	ROSEVILLE
State	:	MI
Zip	:	48066
Country	:	US
Telephone Number	:	586-293-1600
Fax Number	:	586-293-1617

Provider Business Practice Location Address
First Line	:	28909 UTICA ROAD
Second Line	:
City	:	ROSEVILLE
State	:	MI
Zip	:	48066
Country	:	US
Telephone Number	:	586-293-1600
Fax Number	:	586-293-1617

Authorized Official
Title or Position	:	PRESIDENT/ CEO
Name	:	MS. ISABEL D TCRUZ
Credential	:
Telephone Number	:	586-293-1600

Provider Enumeration Date	:	06/08/2005
Last Update Date	:	04/07/2014

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Directions to “MAXICARE HOME HEALTH AGENCY, INC ” Practice Location

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