Provider Demographics
NPI:1407007032
Name:DIVERSIFIED HOME HEALTH CARE INC
Entity Type:Organization
Organization Name:DIVERSIFIED HOME HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:BARBARA
Authorized Official - Last Name:KERR
Authorized Official - Suffix:
Authorized Official - Credentials:RN, CRRN,CCM, CNLCP
Authorized Official - Phone:248-354-2125
Mailing Address - Street 1:6689 ORCHARD LAKE RD
Mailing Address - Street 2:STE 328
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-3404
Mailing Address - Country:US
Mailing Address - Phone:248-354-2125
Mailing Address - Fax:248-359-6203
Practice Address - Street 1:16250 NORTHLAND DR
Practice Address - Street 2:STE 241
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-5205
Practice Address - Country:US
Practice Address - Phone:248-354-2125
Practice Address - Fax:248-359-6203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-01
Last Update Date:2015-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1407007032Medicaid
MI23-9074Medicare PIN