Provider Demographics
NPI:1477613719
Name:MARELI HOME CARE LLC
Entity Type:Organization
Organization Name:MARELI HOME CARE LLC
Other - Org Name:AXIS HOMECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RAMON
Authorized Official - Middle Name:VILLARUEL
Authorized Official - Last Name:VILLANUEVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-720-2117
Mailing Address - Street 1:24333 ORCHARD LAKE RD STE A
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48336-1976
Mailing Address - Country:US
Mailing Address - Phone:248-893-7499
Mailing Address - Fax:248-893-7449
Practice Address - Street 1:24333 ORCHARD LAKE RD STE A
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48336-1976
Practice Address - Country:US
Practice Address - Phone:248-893-7499
Practice Address - Fax:248-893-7449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-09
Last Update Date:2023-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI251E00000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI237752Medicare Oscar/Certification