Provider Demographics
NPI:1861774135
Name:GENERATIONS HOME CARE LLC
Entity type:Organization
Organization Name:GENERATIONS HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:FELICE
Authorized Official - Last Name:SALVIA
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:248-844-9663
Mailing Address - Street 1:1613 STAR BATT DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48309-3706
Mailing Address - Country:US
Mailing Address - Phone:248-844-9663
Mailing Address - Fax:248-844-9652
Practice Address - Street 1:1613 STAR BATT DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48309-3706
Practice Address - Country:US
Practice Address - Phone:248-844-9663
Practice Address - Fax:248-844-9652
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-13
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI237425251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI237425OtherMEDICARE CMS