Provider Demographics
NPI:1245420504
Name:CLASSIC HOME CARE-LIVINGSTON, INC.
Entity Type:Organization
Organization Name:CLASSIC HOME CARE-LIVINGSTON, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:NEELAM
Authorized Official - Middle Name:
Authorized Official - Last Name:GUGLANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-229-2271
Mailing Address - Street 1:135 W NORTH ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48116-1572
Mailing Address - Country:US
Mailing Address - Phone:810-229-2271
Mailing Address - Fax:810-229-7277
Practice Address - Street 1:135 W NORTH ST
Practice Address - Street 2:SUITE 4
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48116-1572
Practice Address - Country:US
Practice Address - Phone:810-229-2271
Practice Address - Fax:810-229-7277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-01
Last Update Date:2008-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI237749Medicare Oscar/Certification