Provider Demographics
NPI:1477122778
Name:AMOR HOMECARE INC OF MICHIGAN
Entity Type:Organization
Organization Name:AMOR HOMECARE INC OF MICHIGAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:AGUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:PRADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-226-0509
Mailing Address - Street 1:11027 106TH ST FL 2
Mailing Address - Street 2:
Mailing Address - City:OZONE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11417-2614
Mailing Address - Country:US
Mailing Address - Phone:917-226-0509
Mailing Address - Fax:
Practice Address - Street 1:3200 GREENFIELD RD STE 300
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48120-1805
Practice Address - Country:US
Practice Address - Phone:917-226-0509
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-21
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI9601542Medicaid