Provider Demographics
NPI:1730460551
Name:CARESS HOME HEALTH CARE SERVICES LLC
Entity Type:Organization
Organization Name:CARESS HOME HEALTH CARE SERVICES LLC
Other - Org Name:CARESS HOME HEALTH CARE SERVICES LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLE
Authorized Official - Middle Name:A
Authorized Official - Last Name:LANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-429-9686
Mailing Address - Street 1:4676 PARKSIDE BLVD
Mailing Address - Street 2:
Mailing Address - City:ALLEN PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48101-3206
Mailing Address - Country:US
Mailing Address - Phone:313-429-9686
Mailing Address - Fax:313-429-9686
Practice Address - Street 1:4676 PARKSIDE BLVD
Practice Address - Street 2:
Practice Address - City:ALLEN PARK
Practice Address - State:MI
Practice Address - Zip Code:48101-3206
Practice Address - Country:US
Practice Address - Phone:313-429-9686
Practice Address - Fax:313-429-9686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-07
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health