Provider Demographics
NPI:1851991699
Name:CACCK ENTERPRISE INC
Entity Type:Organization
Organization Name:CACCK ENTERPRISE INC
Other - Org Name:SENIORS HELPING SENIORS MID MITTEN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:KANOUSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-332-9953
Mailing Address - Street 1:5859 W SAGINAW HWY STE 175
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48917-2460
Mailing Address - Country:US
Mailing Address - Phone:517-332-9953
Mailing Address - Fax:
Practice Address - Street 1:15851 S US 27 STE 314
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48906-1987
Practice Address - Country:US
Practice Address - Phone:517-332-9953
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-30
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care