Provider Demographics
NPI:1255671947
Name:MYCAL HOME CARE
Entity Type:Organization
Organization Name:MYCAL HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:INFANY
Authorized Official - Middle Name:MYCAL
Authorized Official - Last Name:CAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-879-7324
Mailing Address - Street 1:19338 BILTMORE ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48235-2443
Mailing Address - Country:US
Mailing Address - Phone:313-879-7324
Mailing Address - Fax:313-736-3120
Practice Address - Street 1:19338 BILTMORE ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48235-2443
Practice Address - Country:US
Practice Address - Phone:313-879-7324
Practice Address - Fax:313-736-3120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-18
Last Update Date:2013-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health