Provider Demographics
NPI:1588182091
Name:JOHN CHANNING ENTERPRISES, INC
Entity Type:Organization
Organization Name:JOHN CHANNING ENTERPRISES, INC
Other - Org Name:BRIGHTSTAR CARE OF GROSSE POINTE/SOUTHEAST MACOMB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANNING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-279-3610
Mailing Address - Street 1:10822 SPARKLING WATERS CT
Mailing Address - Street 2:
Mailing Address - City:SOUTH LYON
Mailing Address - State:MI
Mailing Address - Zip Code:48178-9494
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:22811 GREATER MACK AVE STE 109
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48080-2053
Practice Address - Country:US
Practice Address - Phone:586-279-3610
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-05
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
1720516156OtherNPI