Provider Demographics
NPI:1043492150
Name:LIFE ESSENTIALS HOME HEALTH CARE, INC
Entity Type:Organization
Organization Name:LIFE ESSENTIALS HOME HEALTH CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR OF NURSING
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:KATRINA
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:313-999-4201
Mailing Address - Street 1:524 FOX HILLS DR S
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48304-1316
Mailing Address - Country:US
Mailing Address - Phone:248-335-0827
Mailing Address - Fax:
Practice Address - Street 1:615 GRISWOLD ST STE 1712
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48226-3990
Practice Address - Country:US
Practice Address - Phone:313-962-2996
Practice Address - Fax:313-962-2997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-30
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704231527251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health