Provider Demographics
NPI:1679624134
Name:FUSION HOME HEALTH CARE AGENCY INC
Entity Type:Organization
Organization Name:FUSION HOME HEALTH CARE AGENCY INC
Other - Org Name:FUSION HOME CARE AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELEAS
Authorized Official - Middle Name:
Authorized Official - Last Name:TELEGADAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-885-5580
Mailing Address - Street 1:3150 LIVERNOIS RD STE 210
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083-5039
Mailing Address - Country:US
Mailing Address - Phone:313-885-5580
Mailing Address - Fax:313-885-5582
Practice Address - Street 1:3150 LIVERNOIS RD STE 210
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48083-5039
Practice Address - Country:US
Practice Address - Phone:313-885-5580
Practice Address - Fax:313-885-5582
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NUERA HEALTH LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-12
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI237644Medicare ID - Type Unspecified