Provider Demographics
NPI:1326125709
Name:VISITING NURSE ASSOCIATION OF SOUTHEAST MICHIGAN
Entity Type:Organization
Organization Name:VISITING NURSE ASSOCIATION OF SOUTHEAST MICHIGAN
Other - Org Name:VISITING NURSE ASSOCIATION OF SE MI
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT &CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:HOUSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-967-9611
Mailing Address - Street 1:25900 GREENFIELD RD
Mailing Address - Street 2:SUITE 600
Mailing Address - City:OAK PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48237-1292
Mailing Address - Country:US
Mailing Address - Phone:248-967-8719
Mailing Address - Fax:248-967-8761
Practice Address - Street 1:25900 GREENFIELD RD
Practice Address - Street 2:SUITE 600
Practice Address - City:OAK PARK
Practice Address - State:MI
Practice Address - Zip Code:48237-1292
Practice Address - Country:US
Practice Address - Phone:248-967-8719
Practice Address - Fax:248-967-8761
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI104701OtherCARE CHOICES
MI5173847Medicaid
MIE001OtherBLUE CROSS BLUE SHIELD
MI1239OtherHEALTH PLAN OF MI
MI5173847OtherMOLINA HEALTH CARE
MI49381OtherOMNICARE
MI119813OtherGREAT LAKES HEALTH PLAN
MI107680OtherTOTAL HEALTH CARE
MI1239OtherHEALTH PLAN OF MI