Provider Demographics
NPI:1275261364
Name:360 HOME HEALTH LLC
Entity Type:Organization
Organization Name:360 HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEGHANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:DECANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-344-8919
Mailing Address - Street 1:206 MARENGO DR
Mailing Address - Street 2:
Mailing Address - City:TEMPERANCE
Mailing Address - State:MI
Mailing Address - Zip Code:48182-9334
Mailing Address - Country:US
Mailing Address - Phone:419-344-8919
Mailing Address - Fax:
Practice Address - Street 1:15226 S TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48161-4064
Practice Address - Country:US
Practice Address - Phone:419-290-2264
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-08
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health