Provider Demographics
NPI:1285865808
Name:MICHIANA HOME CARE, LLC
Entity Type:Organization
Organization Name:MICHIANA HOME CARE, LLC
Other - Org Name:MICHIANA HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:EPERESI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-272-6024
Mailing Address - Street 1:423 SYCAMORE ST STE 104
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:MI
Mailing Address - Zip Code:49120-2374
Mailing Address - Country:US
Mailing Address - Phone:269-687-2900
Mailing Address - Fax:269-687-2903
Practice Address - Street 1:423 SYCAMORE ST STE 104
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:MI
Practice Address - Zip Code:49120-2374
Practice Address - Country:US
Practice Address - Phone:269-687-2900
Practice Address - Fax:269-687-2903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-30
Last Update Date:2024-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI02752J251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health