Provider Demographics
NPI:1245779750
Name:MERIDIAN HOMECARE HOUSEHOLD AND ERRANDS
Entity Type:Organization
Organization Name:MERIDIAN HOMECARE HOUSEHOLD AND ERRANDS
Other - Org Name:NONE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:MRS
Authorized Official - First Name:STACY
Authorized Official - Middle Name:L
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-340-7987
Mailing Address - Street 1:1606 S HURON ST
Mailing Address - Street 2:971725
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-9663
Mailing Address - Country:US
Mailing Address - Phone:734-340-7987
Mailing Address - Fax:
Practice Address - Street 1:7368 MERIDIAN DR
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-9299
Practice Address - Country:US
Practice Address - Phone:734-340-7987
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-16
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704274158251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health