Provider Demographics
NPI:1780638734
Name:COMMUNITY HOME HEALTH CARE OF MICHIGAN, INC.
Entity Type:Organization
Organization Name:COMMUNITY HOME HEALTH CARE OF MICHIGAN, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:LEESTMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-689-6675
Mailing Address - Street 1:175 S GIBBS ST
Mailing Address - Street 2:
Mailing Address - City:WHITE CLOUD
Mailing Address - State:MI
Mailing Address - Zip Code:49349-9401
Mailing Address - Country:US
Mailing Address - Phone:231-689-6675
Mailing Address - Fax:231-689-5038
Practice Address - Street 1:175 S GIBBS ST
Practice Address - Street 2:
Practice Address - City:WHITE CLOUD
Practice Address - State:MI
Practice Address - Zip Code:49349-9401
Practice Address - Country:US
Practice Address - Phone:231-689-6675
Practice Address - Fax:231-689-5038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5174002Medicaid
MI237035Medicare ID - Type UnspecifiedHOME HEALTH AGENCY PROVID