Provider Demographics
NPI:1407818172
Name:QUALITY HOME HEALTH CARE SERVICES OF MICHIGAN,INC.
Entity Type:Organization
Organization Name:QUALITY HOME HEALTH CARE SERVICES OF MICHIGAN,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:GILLIAM
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:313-410-8870
Mailing Address - Street 1:23800 WEST.TEN MILE RD. STE 250
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034
Mailing Address - Country:US
Mailing Address - Phone:248-350-0014
Mailing Address - Fax:
Practice Address - Street 1:23800 WEST.TEN MILE RD
Practice Address - Street 2:STE 250
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034
Practice Address - Country:US
Practice Address - Phone:248-350-0014
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-06
Last Update Date:2010-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI237482251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI237482Medicare ID - Type UnspecifiedHOME HEALTH AGENCY