Provider Demographics
NPI:1629763982
Name:METRO PRESTIGIOUS HOME SERVICES LLC
Entity Type:Organization
Organization Name:METRO PRESTIGIOUS HOME SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:TATIANNA
Authorized Official - Middle Name:D
Authorized Official - Last Name:TYE
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:249-929-2930
Mailing Address - Street 1:25535 CATALINA ST # A
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-1774
Mailing Address - Country:US
Mailing Address - Phone:249-929-2930
Mailing Address - Fax:
Practice Address - Street 1:17520 W 12 MILE RD # 206
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-1945
Practice Address - Country:US
Practice Address - Phone:248-929-2930
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-11
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health