Provider Demographics
NPI:1710193818
Name:PARRISH HOME SUPPORT
Entity Type:Organization
Organization Name:PARRISH HOME SUPPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:H
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:248-547-5778
Mailing Address - Street 1:27332 WOODWARD AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48067-0900
Mailing Address - Country:US
Mailing Address - Phone:248-547-5778
Mailing Address - Fax:248-547-6077
Practice Address - Street 1:27332 WOODWARD AVE STE 200
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48067-0900
Practice Address - Country:US
Practice Address - Phone:248-547-5778
Practice Address - Fax:248-547-6077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIB75566251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health