Provider Demographics
NPI:1053854240
Name:MICHIGAN HOME CARE GROUP, LLC
Entity Type:Organization
Organization Name:MICHIGAN HOME CARE GROUP, LLC
Other - Org Name:MICHIGAN HOME CARE GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:MACERI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-690-5062
Mailing Address - Street 1:51424 VAN DYKE AVE
Mailing Address - Street 2:SUITE 11
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48316-4406
Mailing Address - Country:US
Mailing Address - Phone:586-690-5062
Mailing Address - Fax:586-749-4993
Practice Address - Street 1:51424 VAN DYKE AVE
Practice Address - Street 2:SUITE 11
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48316-4406
Practice Address - Country:US
Practice Address - Phone:586-690-5062
Practice Address - Fax:586-749-4993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-21
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care