Provider Demographics
NPI:1477314045
Name:ELDERCARE SUPPORT SERVICES LLC
Entity Type:Organization
Organization Name:ELDERCARE SUPPORT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANTOINETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:GIMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-719-2508
Mailing Address - Street 1:35252 SIMON DR
Mailing Address - Street 2:
Mailing Address - City:CLINTON TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48035-5002
Mailing Address - Country:US
Mailing Address - Phone:586-719-2508
Mailing Address - Fax:
Practice Address - Street 1:35252 SIMON DR
Practice Address - Street 2:
Practice Address - City:CLINTON TWP
Practice Address - State:MI
Practice Address - Zip Code:48035-5002
Practice Address - Country:US
Practice Address - Phone:586-719-2508
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-19
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care