Provider Demographics
NPI:1164645461
Name:LAKE CITY HOME HEALTH CARE, INC.
Entity Type:Organization
Organization Name:LAKE CITY HOME HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SYED
Authorized Official - Middle Name:T
Authorized Official - Last Name:AKHTAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-377-2094
Mailing Address - Street 1:5880 N CANTON CENTER RD
Mailing Address - Street 2:SUITE 410
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-2686
Mailing Address - Country:US
Mailing Address - Phone:734-377-2094
Mailing Address - Fax:734-254-0004
Practice Address - Street 1:5880 CANTON CENTER RD
Practice Address - Street 2:SUITE 410
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-2686
Practice Address - Country:US
Practice Address - Phone:734-644-3111
Practice Address - Fax:734-727-1579
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health