Provider Demographics
NPI:1083885420
Name:CHRISTIAN HOME HEALTH CARE
Entity Type:Organization
Organization Name:CHRISTIAN HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PERCY
Authorized Official - Middle Name:
Authorized Official - Last Name:PETER
Authorized Official - Suffix:
Authorized Official - Credentials:PT EDD
Authorized Official - Phone:586-412-1111
Mailing Address - Street 1:42657 GARFIELD RD
Mailing Address - Street 2:SUITE 217
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-5023
Mailing Address - Country:US
Mailing Address - Phone:586-412-1111
Mailing Address - Fax:
Practice Address - Street 1:42657 GARFIELD RD
Practice Address - Street 2:SUITE 217
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038-5023
Practice Address - Country:US
Practice Address - Phone:586-412-1111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:POBLO INTERNATIONAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-03-13
Last Update Date:2009-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI23-9038Medicare PIN