Provider Demographics
NPI:1881839736
Name:AGILITY HOMECARE INC
Entity Type:Organization
Organization Name:AGILITY HOMECARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:248-557-3243
Mailing Address - Street 1:17200 W 10 MILE RD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-2928
Mailing Address - Country:US
Mailing Address - Phone:248-557-3243
Mailing Address - Fax:248-557-3250
Practice Address - Street 1:17200 W 10 MILE RD
Practice Address - Street 2:SUITE 206
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-2928
Practice Address - Country:US
Practice Address - Phone:248-557-3243
Practice Address - Fax:248-557-3250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-06
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
N/A251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health