Provider Demographics
NPI:1619733409
Name:CHA-RAE'S CARE
Entity Type:Organization
Organization Name:CHA-RAE'S CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CAREGIVER
Authorized Official - Prefix:
Authorized Official - First Name:CHA-RAE
Authorized Official - Middle Name:
Authorized Official - Last Name:MYATT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-844-8683
Mailing Address - Street 1:100 RIVERFRONT DR APT 805
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48226-4537
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 RIVERFRONT DR APT 805
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48226-4537
Practice Address - Country:US
Practice Address - Phone:313-844-8683
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-28
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health