Provider Demographics
NPI:1902981814
Name:DYNAMIC HOME CARE SERVICES, INC.
Entity Type:Organization
Organization Name:DYNAMIC HOME CARE SERVICES, INC.
Other - Org Name:DYNAMIC HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:THELMA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:MSN
Authorized Official - Phone:248-379-7999
Mailing Address - Street 1:24001 SOUTHFIELD RD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-2816
Mailing Address - Country:US
Mailing Address - Phone:248-905-5022
Mailing Address - Fax:248-905-5203
Practice Address - Street 1:24001 SOUTHFIELD RD
Practice Address - Street 2:SUITE 205
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-2816
Practice Address - Country:US
Practice Address - Phone:248-905-5022
Practice Address - Fax:248-905-5203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2013-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI237445Medicare ID - Type UnspecifiedHOME HEALTH CARE