Provider Demographics
NPI:1538406855
Name:DYNAMIC HOME HEALTH CARE AGENCY
Entity type:Organization
Organization Name:DYNAMIC HOME HEALTH CARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:COMFORT
Authorized Official - Middle Name:
Authorized Official - Last Name:UMOREN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:248-910-9487
Mailing Address - Street 1:3744 LINCOLN DRIVE
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48301
Mailing Address - Country:US
Mailing Address - Phone:248-910-9487
Mailing Address - Fax:248-885-8827
Practice Address - Street 1:3744 LINCOLN DRIVE
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48301
Practice Address - Country:US
Practice Address - Phone:248-910-9487
Practice Address - Fax:248-885-8827
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-07
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI251B00000X, 251F00000X, 253Z00000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management
No251F00000XAgenciesHome Infusion
No253Z00000XAgenciesIn Home Supportive Care