Provider Demographics
NPI:1609896208
Name:JOHN PAUL HOME CARE, LLC
Entity Type:Organization
Organization Name:JOHN PAUL HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:GROWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-325-1176
Mailing Address - Street 1:30600 TELEGRAPH RD
Mailing Address - Street 2:SUITE 2370
Mailing Address - City:BINGHAM FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48025-4530
Mailing Address - Country:US
Mailing Address - Phone:248-731-7457
Mailing Address - Fax:
Practice Address - Street 1:30600 TELEGRAPH RD
Practice Address - Street 2:SUITE 2370
Practice Address - City:BINGHAM FARMS
Practice Address - State:MI
Practice Address - Zip Code:48025-4530
Practice Address - Country:US
Practice Address - Phone:248-731-7457
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI237659Medicare Oscar/Certification