Provider Demographics
NPI:1780681908
Name:CENTRAL HOME HEALTH CARE, INC.
Entity Type:Organization
Organization Name:CENTRAL HOME HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MR
Authorized Official - First Name:VIJAY
Authorized Official - Middle Name:
Authorized Official - Last Name:WALVEKAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-569-5410
Mailing Address - Street 1:20245 W 12 MILE RD
Mailing Address - Street 2:STE 100
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-9920
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:20245 W 12 MILE RD
Practice Address - Street 2:STE 100
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-9920
Practice Address - Country:US
Practice Address - Phone:248-569-5410
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-01
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
MIOE-852OtherBCBS
MI1677587Medicaid
MIOE-852OtherBCBS