Provider Demographics
NPI:1073373163
Name:LIVE LONG HOME CARE
Entity Type:Organization
Organization Name:LIVE LONG HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENCY OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAHRIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SULTANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-747-5642
Mailing Address - Street 1:7747 MOUNT ELLIOTT ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48211-1823
Mailing Address - Country:US
Mailing Address - Phone:248-238-9835
Mailing Address - Fax:
Practice Address - Street 1:7747 MOUNT ELLIOTT ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48211-1823
Practice Address - Country:US
Practice Address - Phone:248-238-9835
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-19
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care