Provider Demographics
NPI:1568894392
Name:SUSTAINING HOME CARE AGENCY LLC
Entity Type:Organization
Organization Name:SUSTAINING HOME CARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENCY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:LANORA
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-214-0213
Mailing Address - Street 1:30844 CREST FRST
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48331-1086
Mailing Address - Country:US
Mailing Address - Phone:855-787-4664
Mailing Address - Fax:855-787-4664
Practice Address - Street 1:30844 CREST FRST
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48331-1086
Practice Address - Country:US
Practice Address - Phone:855-787-4664
Practice Address - Fax:855-787-4664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-03
Last Update Date:2013-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
No253Z00000XAgenciesIn Home Supportive Care