Provider Demographics
NPI:1609297142
Name:MICHIGAN HERITAGE HOME CARE, LLC.
Entity Type:Organization
Organization Name:MICHIGAN HERITAGE HOME CARE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHINUELU
Authorized Official - Middle Name:A
Authorized Official - Last Name:ANWUNAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-987-1133
Mailing Address - Street 1:20232 FARMINGTON RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-1497
Mailing Address - Country:US
Mailing Address - Phone:248-987-1133
Mailing Address - Fax:248-987-1134
Practice Address - Street 1:20232 FARMINGTON RD
Practice Address - Street 2:SUITE A
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-1497
Practice Address - Country:US
Practice Address - Phone:248-987-1133
Practice Address - Fax:248-987-1134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-31
Last Update Date:2013-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health