Provider Demographics
NPI:1376106500
Name:EZZY; INC
Entity Type:Organization
Organization Name:EZZY; INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:IMMACULATA
Authorized Official - Middle Name:O
Authorized Official - Last Name:AMMANZE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-890-3360
Mailing Address - Street 1:28425 BROOKS LN
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-2090
Mailing Address - Country:US
Mailing Address - Phone:248-890-3360
Mailing Address - Fax:248-200-7200
Practice Address - Street 1:28425 BROOKS LN
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-2090
Practice Address - Country:US
Practice Address - Phone:248-890-3360
Practice Address - Fax:248-200-7200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-14
Last Update Date:2019-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health