Provider Demographics
NPI:1801189204
Name:AMERICAN HOMECARE HOSPICE LLC
Entity Type:Organization
Organization Name:AMERICAN HOMECARE HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NAFIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:MIRZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-846-4483
Mailing Address - Street 1:4245 S BEECH DALY ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48125-1567
Mailing Address - Country:US
Mailing Address - Phone:734-846-4483
Mailing Address - Fax:313-277-5502
Practice Address - Street 1:4245 S BEECH DALY ST
Practice Address - Street 2:SUITE 201
Practice Address - City:DEARBORN HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48125-1567
Practice Address - Country:US
Practice Address - Phone:734-846-4483
Practice Address - Fax:313-277-5502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-18
Last Update Date:2011-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based