Provider Demographics
NPI:1144562646
Name:NEUROCARE HOME HEALTH, LLC
Entity Type:Organization
Organization Name:NEUROCARE HOME HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:NICK
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:LONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-714-1313
Mailing Address - Street 1:1604 WOODSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:ESSEXVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48732-1459
Mailing Address - Country:US
Mailing Address - Phone:989-402-1966
Mailing Address - Fax:988-509-5912
Practice Address - Street 1:1604 WOODSIDE AVE
Practice Address - Street 2:
Practice Address - City:ESSEXVILLE
Practice Address - State:MI
Practice Address - Zip Code:48732-1459
Practice Address - Country:US
Practice Address - Phone:989-402-1966
Practice Address - Fax:989-509-5912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-22
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health