Provider Demographics
NPI:1205215142
Name:REFORMATION HOME HEALTH LLC
Entity Type:Organization
Organization Name:REFORMATION HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:BIGELOW
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:810-513-0202
Mailing Address - Street 1:3014 YALE ST
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48503-6800
Mailing Address - Country:US
Mailing Address - Phone:810-513-0202
Mailing Address - Fax:313-202-8313
Practice Address - Street 1:412 S. SAGINAW ST
Practice Address - Street 2:SUITE 301
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507
Practice Address - Country:US
Practice Address - Phone:810-513-0202
Practice Address - Fax:313-202-8313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-26
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health