Provider Demographics
NPI:1659833457
Name:MHC AREA 4, LLC
Entity Type:Organization
Organization Name:MHC AREA 4, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:SAAGMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-228-8388
Mailing Address - Street 1:885 PENNIMAN AVE UNIT 6426
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-7722
Mailing Address - Country:US
Mailing Address - Phone:734-560-8953
Mailing Address - Fax:954-337-3112
Practice Address - Street 1:712 S OCEAN SHORE BLVD
Practice Address - Street 2:
Practice Address - City:FLAGLER BEACH
Practice Address - State:FL
Practice Address - Zip Code:32136-3602
Practice Address - Country:US
Practice Address - Phone:734-560-8953
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-02
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health