Provider Demographics
NPI:1437543048
Name:KOM4CARE HOME HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:KOM4CARE HOME HEALTH SERVICES LLC
Other - Org Name:KOM4CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AIESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:248-225-4681
Mailing Address - Street 1:17832 ANNOTT ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48205-3106
Mailing Address - Country:US
Mailing Address - Phone:248-225-4681
Mailing Address - Fax:
Practice Address - Street 1:17832 ANNOTT ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48205-3106
Practice Address - Country:US
Practice Address - Phone:248-225-4681
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-20
Last Update Date:2015-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI230121850498251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care