Provider Demographics
NPI:1174825186
Name:HOMELAND HOME HEALTHCARE SERVICES LLC
Entity Type:Organization
Organization Name:HOMELAND HOME HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TABI
Authorized Official - Middle Name:PIUS
Authorized Official - Last Name:ESSA
Authorized Official - Suffix:
Authorized Official - Credentials:MBA/HCM
Authorized Official - Phone:240-374-2157
Mailing Address - Street 1:1425 E DUBLIN GRANVILLE RD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-3325
Mailing Address - Country:US
Mailing Address - Phone:240-374-2157
Mailing Address - Fax:614-985-0585
Practice Address - Street 1:16623 SCHAEFER HIGHWAY
Practice Address - Street 2:SUITE 18
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48235-5215
Practice Address - Country:US
Practice Address - Phone:240-374-2157
Practice Address - Fax:614-985-0585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-23
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MID5166L251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health