Provider Demographics
NPI:1528223666
Name:GRAND HOME CARE, LLC
Entity Type:Organization
Organization Name:GRAND HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:RUNYON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:586-707-1446
Mailing Address - Street 1:8033 E 10 MILE RD
Mailing Address - Street 2:SUITE 114
Mailing Address - City:CENTER LINE
Mailing Address - State:MI
Mailing Address - Zip Code:48015-1427
Mailing Address - Country:US
Mailing Address - Phone:586-707-1446
Mailing Address - Fax:586-756-6933
Practice Address - Street 1:8033 E 10 MILE RD
Practice Address - Street 2:SUITE 114
Practice Address - City:CENTER LINE
Practice Address - State:MI
Practice Address - Zip Code:48015-1427
Practice Address - Country:US
Practice Address - Phone:586-707-1446
Practice Address - Fax:586-756-6933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-28
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health