Provider Demographics
NPI:1316583768
Name:MIESHA S IN-HOME CARE LLC
Entity Type:Organization
Organization Name:MIESHA S IN-HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MIESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRANAGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-443-4117
Mailing Address - Street 1:1902 COLOMBARD CIR
Mailing Address - Street 2:
Mailing Address - City:LODI
Mailing Address - State:CA
Mailing Address - Zip Code:95240-6171
Mailing Address - Country:US
Mailing Address - Phone:209-443-4117
Mailing Address - Fax:
Practice Address - Street 1:1902 COLOMBARD CIR
Practice Address - Street 2:
Practice Address - City:LODI
Practice Address - State:CA
Practice Address - Zip Code:95240-6171
Practice Address - Country:US
Practice Address - Phone:209-443-4117
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-20
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health