Provider Demographics
NPI:1104006469
Name:HOME HEALTHCARE PROFESSIONALS
Entity Type:Organization
Organization Name:HOME HEALTHCARE PROFESSIONALS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:ERICKA
Authorized Official - Middle Name:TENEE
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:906-774-4933
Mailing Address - Street 1:733 CASS AVE
Mailing Address - Street 2:
Mailing Address - City:KINGSFORD
Mailing Address - State:MI
Mailing Address - Zip Code:49802-4401
Mailing Address - Country:US
Mailing Address - Phone:906-774-4933
Mailing Address - Fax:906-774-4033
Practice Address - Street 1:733 CASS AVE
Practice Address - Street 2:
Practice Address - City:KINGSFORD
Practice Address - State:MI
Practice Address - Zip Code:49802
Practice Address - Country:US
Practice Address - Phone:906-774-4933
Practice Address - Fax:906-774-4033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-05
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health