Provider Demographics
NPI:1255495149
Name:EXCEED HOME HEALTH SYSTEM, INC.
Entity Type:Organization
Organization Name:EXCEED HOME HEALTH SYSTEM, INC.
Other - Org Name:TRINITY HOME HEALTH SYSTEM, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FLORANTE
Authorized Official - Middle Name:I
Authorized Official - Last Name:TUBAY
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:734-941-2120
Mailing Address - Street 1:17810 TELEGRAPH RD
Mailing Address - Street 2:
Mailing Address - City:BROWNSTOWN
Mailing Address - State:MI
Mailing Address - Zip Code:48174-9545
Mailing Address - Country:US
Mailing Address - Phone:734-941-2120
Mailing Address - Fax:734-941-0560
Practice Address - Street 1:17810 TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:BROWNSTOWN
Practice Address - State:MI
Practice Address - Zip Code:48174-9545
Practice Address - Country:US
Practice Address - Phone:734-941-2120
Practice Address - Fax:734-941-0560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2009-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704236598251E00000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI237729Medicare Oscar/Certification