Provider Demographics
NPI:1902832579
Name:FIRST IMPRESSIONS HEALTH CARE SOLUTIONS, LLC
Entity Type:Organization
Organization Name:FIRST IMPRESSIONS HEALTH CARE SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:AYAZ
Authorized Official - Middle Name:
Authorized Official - Last Name:MOIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-254-3708
Mailing Address - Street 1:31500 W 13 MILE RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-2164
Mailing Address - Country:US
Mailing Address - Phone:248-254-3708
Mailing Address - Fax:248-479-5688
Practice Address - Street 1:31500 W 13 MILE RD
Practice Address - Street 2:SUITE 210
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-2164
Practice Address - Country:US
Practice Address - Phone:248-254-3708
Practice Address - Fax:248-479-5688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2016-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI23-9267Medicare PIN