Provider Demographics
NPI:1578817417
Name:HOME HELPERS COMPANION AGENCY,LLC
Entity Type:Organization
Organization Name:HOME HELPERS COMPANION AGENCY,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:KRISTY
Authorized Official - Middle Name:J
Authorized Official - Last Name:ELLSWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-908-9100
Mailing Address - Street 1:PO BOX 332
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:MI
Mailing Address - Zip Code:49665-0332
Mailing Address - Country:US
Mailing Address - Phone:231-908-9100
Mailing Address - Fax:
Practice Address - Street 1:208 E. MAIN ST.
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:MI
Practice Address - Zip Code:49665
Practice Address - Country:US
Practice Address - Phone:231-908-9100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-30
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health