Provider Demographics
NPI:1619558723
Name:BASELINE HUMAN AND HEALTH SERVICES
Entity Type:Organization
Organization Name:BASELINE HUMAN AND HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-325-7184
Mailing Address - Street 1:29615 GREENING ST
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-2245
Mailing Address - Country:US
Mailing Address - Phone:248-325-7184
Mailing Address - Fax:
Practice Address - Street 1:29615 GREENING ST
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-2245
Practice Address - Country:US
Practice Address - Phone:248-325-7184
Practice Address - Fax:248-479-0320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-20
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI9521503Medicaid