Provider Demographics
NPI:1588645980
Name:SENIOR HOME HEALTH CARE INC
Entity Type:Organization
Organization Name:SENIOR HOME HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:G
Authorized Official - Last Name:HALLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-363-7575
Mailing Address - Street 1:4204 MARTIN RD
Mailing Address - Street 2:SUITE E
Mailing Address - City:COMMERCE TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48390-4135
Mailing Address - Country:US
Mailing Address - Phone:248-363-7575
Mailing Address - Fax:248-363-9214
Practice Address - Street 1:4204 MARTIN RD
Practice Address - Street 2:SUITE E
Practice Address - City:COMMERCE TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48390-4135
Practice Address - Country:US
Practice Address - Phone:248-363-7575
Practice Address - Fax:248-363-9214
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2684844Medicaid
MI54OF30711OtherBLUE CROSS BLUE SHIELD MI
MI2684844Medicaid