MEDICARE: VCCF HOME CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	104100000X	Social Worker
2	207R00000X	Internal Medicine Physician
3	225100000X	Physical Therapist
4	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1962915132
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VCCF HOME CARE LLC

Provider Business Mailing Address
First Line	:	27739 JEFFERSON AVE
Second Line	:
City	:	SAINT CLAIR SHORES
State	:	MI
Zip	:	48081-1309
Country	:	US
Telephone Number	:	586-777-2115
Fax Number	:	313-731-1943

Provider Business Practice Location Address
First Line	:	27739 JEFFERSON AVE
Second Line	:
City	:	SAINT CLAIR SHORES
State	:	MI
Zip	:	48081-1309
Country	:	US
Telephone Number	:	586-777-2115
Fax Number	:	313-731-1943

Authorized Official
Title or Position	:	EXECUTIVE VICE PRESIDENT
Name	:	MARY BETH RYAN
Credential	:
Telephone Number	:	586-777-2115

Provider Enumeration Date	:	11/09/2017
Last Update Date	:	12/15/2017

Similar Medicare Providers

1114046976 — MARTIN J FRASCHETTI, D.D.S., FAMILY DENTISTRY P.C.
Practice Location Address:

27731 JEFFERSON AVE
SAINT CLAIR SHORES, MI
48081-1309

Practice Phone: 586-773-1212
Practice Fax: 586-778-5756

1326167255 — DR. KAREN M BRATUS D.D.S.
Practice Location Address:

27731 JEFFERSON AVE
SAINT CLAIR SHORES, MI
48081-1309

Practice Phone: 586-773-1212
Practice Fax: 586-778-5756

1558482430 — DR. MARTIN J FRASCHETTI D.D.S.,F.I.C.C.M.O.
Practice Location Address:

27731 JEFFERSON AVE
SAINT CLAIR SHORES, MI
48081-1309

Practice Phone: 586-773-1212
Practice Fax: 586-778-5756

1417361361 — CYNTHIA SHIELDS N.P.
Practice Location Address:

27739 JEFFERSON AVE
SAINT CLAIR SHORES, MI
48081-1309

Practice Phone: 586-315-2874
Practice Fax: 586-231-3811

1902203227 — MICHIGAN PRIVATE DENTAL GROUP
Practice Location Address:

27731 JEFFERSON AVE
SAINT CLAIR SHORES, MI
48081-1309

Practice Phone: 586-771-6440
Practice Fax: 586-771-8877

1023554540 — MS. KATHLEEN MARIE VANNESTE-KORTEBEIN LPC
Practice Location Address:

27735 JEFFERSON AVE
SAINT CLAIR SHORES, MI
48081-1309

Practice Phone: 586-777-8929
Practice Fax:

Directions to “VCCF HOME CARE LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.