Provider Demographics
NPI:1891046470
Name:HENDERSON HOME HEALTH CARE LLC
Entity Type:Organization
Organization Name:HENDERSON HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:O
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-325-8893
Mailing Address - Street 1:21700 GREENFIELD RD
Mailing Address - Street 2:SUITE LL 20
Mailing Address - City:OAK PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48237-2581
Mailing Address - Country:US
Mailing Address - Phone:248-325-8893
Mailing Address - Fax:888-758-5597
Practice Address - Street 1:21700 GREENFIELD RD
Practice Address - Street 2:SUITE LL 20
Practice Address - City:OAK PARK
Practice Address - State:MI
Practice Address - Zip Code:48237-2581
Practice Address - Country:US
Practice Address - Phone:248-325-8893
Practice Address - Fax:888-758-5597
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-24
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health