Provider Demographics
NPI:1558491829
Name:VNA CARING HOME SUPPORT, INC
Entity Type:Organization
Organization Name:VNA CARING HOME SUPPORT, INC
Other - Org Name:VISITING NURSE ASSOCIATION PRIVATE CARE
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:FISHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MSN
Authorized Official - Phone:248-683-1770
Mailing Address - Street 1:959 W HURON ST
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48328-3727
Mailing Address - Country:US
Mailing Address - Phone:248-683-1770
Mailing Address - Fax:248-683-1774
Practice Address - Street 1:959 W HURON ST
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48328-3727
Practice Address - Country:US
Practice Address - Phone:248-683-1770
Practice Address - Fax:248-683-1774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2015-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI251E00000X, 251F00000X, 251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
No251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0990636OtherHEALTH PLUS OF MICHIGAN
MI600001578OtherPALMETTO GBA
MIH3084855OtherCONNECTICUT GENERAL LIFE
MI125929OtherCARE CHOICES
MI125929OtherCARE CHOICES
MI600001578OtherPALMETTO GBA
MIOM13210Medicare ID - Type UnspecifiedWISCONSIN PHYTSICIAN SERV