Provider Demographics
NPI:1760799639
Name:CEDAR HEALTH CARE LLC
Entity Type:Organization
Organization Name:CEDAR HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O./ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RAM
Authorized Official - Middle Name:
Authorized Official - Last Name:KANCHARLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-887-0832
Mailing Address - Street 1:100 W KIRBY ST
Mailing Address - Street 2:SUITE 306
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48202-4044
Mailing Address - Country:US
Mailing Address - Phone:313-887-0832
Mailing Address - Fax:313-887-9452
Practice Address - Street 1:100 W KIRBY ST
Practice Address - Street 2:SUITE 306
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-4044
Practice Address - Country:US
Practice Address - Phone:313-887-0832
Practice Address - Fax:313-887-9452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-13
Last Update Date:2010-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health