Provider Demographics
NPI:1902917644
Name:MICHIGAN HOME HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:MICHIGAN HOME HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:NAILA
Authorized Official - Middle Name:
Authorized Official - Last Name:IMTIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-471-6202
Mailing Address - Street 1:23030 MOONEY
Mailing Address - Street 2:SUITE A
Mailing Address - City:FARMINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:48336
Mailing Address - Country:US
Mailing Address - Phone:248-471-6202
Mailing Address - Fax:248-471-6204
Practice Address - Street 1:23030 MOONEY
Practice Address - Street 2:SUITE A
Practice Address - City:FARMINGTON
Practice Address - State:MI
Practice Address - Zip Code:48336
Practice Address - Country:US
Practice Address - Phone:248-471-6202
Practice Address - Fax:248-471-6204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI237515251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI237515Medicare ID - Type Unspecified