Provider Demographics
NPI:1821042250
Name:SUMMIT HOME CARE INC
Entity Type:Organization
Organization Name:SUMMIT HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:KAJARI
Authorized Official - Middle Name:
Authorized Official - Last Name:GAYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-533-1400
Mailing Address - Street 1:26370 GRAND RIVER AVE
Mailing Address - Street 2:
Mailing Address - City:REDFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48240-1463
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:26370 GRAND RIVER AVE
Practice Address - Street 2:
Practice Address - City:REDFORD
Practice Address - State:MI
Practice Address - Zip Code:48240-1463
Practice Address - Country:US
Practice Address - Phone:313-533-1400
Practice Address - Fax:313-533-1402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI03639E251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health