Provider Demographics
NPI:1578137204
Name:SALUBRIOUS HOME CARE
Entity Type:Organization
Organization Name:SALUBRIOUS HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:GELDERSMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-660-1377
Mailing Address - Street 1:2833 MONTANA AVE
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48506-2449
Mailing Address - Country:US
Mailing Address - Phone:810-660-1377
Mailing Address - Fax:
Practice Address - Street 1:2833 MONTANA AVE
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48506-2449
Practice Address - Country:US
Practice Address - Phone:810-660-1377
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-17
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health