Provider Demographics
NPI:1225880602
Name:CARDINAL HOME HEALTHCARE GROUP, LLC
Entity Type:Organization
Organization Name:CARDINAL HOME HEALTHCARE GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:MONSENIOR
Authorized Official - Middle Name:
Authorized Official - Last Name:CARDENAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-435-9460
Mailing Address - Street 1:35324 EDYTHE DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48331-2025
Mailing Address - Country:US
Mailing Address - Phone:586-203-8118
Mailing Address - Fax:800-558-4559
Practice Address - Street 1:3165 OAKMAN BLVD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48238-3194
Practice Address - Country:US
Practice Address - Phone:586-203-8118
Practice Address - Fax:800-558-4559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty