Provider Demographics
NPI:1164173910
Name:NURSE AT HOME, HOME HEALTH CARE, LLC
Entity Type:Organization
Organization Name:NURSE AT HOME, HOME HEALTH CARE, LLC
Other - Org Name:NURSE AT HOME HOME HEALTH CARE, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECT OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:HUDSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:586-933-8032
Mailing Address - Street 1:18565 FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:EASTPOINTE
Mailing Address - State:MI
Mailing Address - Zip Code:48021-1302
Mailing Address - Country:US
Mailing Address - Phone:586-933-8032
Mailing Address - Fax:586-300-1200
Practice Address - Street 1:18565 FOREST AVE
Practice Address - Street 2:
Practice Address - City:EASTPOINTE
Practice Address - State:MI
Practice Address - Zip Code:48021-1302
Practice Address - Country:US
Practice Address - Phone:586-571-4343
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-13
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health