Provider Demographics
NPI:1619450772
Name:HOME HEALTH & WELLNESS, LLC
Entity Type:Organization
Organization Name:HOME HEALTH & WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:T
Authorized Official - Last Name:WALTERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-398-0425
Mailing Address - Street 1:PO BOX 835
Mailing Address - Street 2:
Mailing Address - City:HILLSDALE
Mailing Address - State:MI
Mailing Address - Zip Code:49242-0835
Mailing Address - Country:US
Mailing Address - Phone:517-398-0425
Mailing Address - Fax:517-292-2482
Practice Address - Street 1:67 E SAINT JOE ST
Practice Address - Street 2:
Practice Address - City:HILLSDALE
Practice Address - State:MI
Practice Address - Zip Code:49242-1757
Practice Address - Country:US
Practice Address - Phone:517-398-0425
Practice Address - Fax:517-292-2482
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-13
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health