Provider Demographics
NPI:1760174155
Name:CLEAR VISION HOME CARE AGENCY LLC
Entity Type:Organization
Organization Name:CLEAR VISION HOME CARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SADE
Authorized Official - Middle Name:MONIQUE
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-909-3067
Mailing Address - Street 1:40563 EMERALD LN W
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-4753
Mailing Address - Country:US
Mailing Address - Phone:586-909-3067
Mailing Address - Fax:
Practice Address - Street 1:40563 EMERALD LN W
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038-4753
Practice Address - Country:US
Practice Address - Phone:586-909-3067
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-23
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health