Provider Demographics
NPI:1407284219
Name:RHETT ENTERPRISES, INC.
Entity Type:Organization
Organization Name:RHETT ENTERPRISES, INC.
Other - Org Name:MAGNA CARE HOME HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:HIBLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-552-1111
Mailing Address - Street 1:29200 SOUTHFIELD RD
Mailing Address - Street 2:SUITE 102A
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-1906
Mailing Address - Country:US
Mailing Address - Phone:248-552-1111
Mailing Address - Fax:248-552-1114
Practice Address - Street 1:29200 SOUTHFIELD RD
Practice Address - Street 2:SUITE 102A
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-1906
Practice Address - Country:US
Practice Address - Phone:248-552-1111
Practice Address - Fax:248-552-1114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-15
Last Update Date:2016-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI700H714320OtherBLUE CROSS
MI1407284219Medicaid
MIMI7267Medicare PIN