Provider Demographics
NPI:1427201409
Name:TANGERINE ROSE HOME HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:TANGERINE ROSE HOME HEALTHCARE SERVICES
Other - Org Name:TANGERINE ROSE HHC SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:DUOWANA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:PEARCY
Authorized Official - Suffix:
Authorized Official - Credentials:DIRECT CARE STAFFING
Authorized Official - Phone:313-766-0496
Mailing Address - Street 1:14148 SALEM
Mailing Address - Street 2:
Mailing Address - City:REDFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48239-2812
Mailing Address - Country:US
Mailing Address - Phone:313-766-0496
Mailing Address - Fax:313-766-0496
Practice Address - Street 1:14148 SALEM
Practice Address - Street 2:
Practice Address - City:REDFORD
Practice Address - State:MI
Practice Address - Zip Code:48239-2812
Practice Address - Country:US
Practice Address - Phone:313-766-0496
Practice Address - Fax:313-766-0496
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-04
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI251E00000X
MIPENDING320700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities