Provider Demographics
NPI:1689002719
Name:MACOMB-OAKLAND HOME CARE, INC.
Entity Type:Organization
Organization Name:MACOMB-OAKLAND HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:THAWRA
Authorized Official - Middle Name:JULIA
Authorized Official - Last Name:WARDIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-944-4096
Mailing Address - Street 1:1999 COMMON RD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48092-2164
Mailing Address - Country:US
Mailing Address - Phone:586-944-4096
Mailing Address - Fax:586-283-6127
Practice Address - Street 1:1999 COMMON RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48092-2164
Practice Address - Country:US
Practice Address - Phone:586-944-4096
Practice Address - Fax:586-283-6127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-29
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health