Provider Demographics
NPI:1902019490
Name:NORTH OAKLAND HOME HEALTH CARE, INC.
Entity Type:Organization
Organization Name:NORTH OAKLAND HOME HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LANCE
Authorized Official - Middle Name:MORGAN
Authorized Official - Last Name:BAYLIS
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:248-625-5865
Mailing Address - Street 1:7736 ORTONVILLE RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48348-4483
Mailing Address - Country:US
Mailing Address - Phone:248-625-5865
Mailing Address - Fax:248-625-9141
Practice Address - Street 1:7736 ORTONVILLE RD
Practice Address - Street 2:SUITE B
Practice Address - City:CLARKSTON
Practice Address - State:MI
Practice Address - Zip Code:48348-4483
Practice Address - Country:US
Practice Address - Phone:248-625-5865
Practice Address - Fax:248-625-9141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI23-7122251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIOEO22OtherBCBSM PROVIDER NUMBER
MI517-4684Medicaid
MI517-4684Medicaid