Provider Demographics
NPI:1912203563
Name:HOME CARE WELLNESS LLC
Entity Type:Organization
Organization Name:HOME CARE WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:WAQAS
Authorized Official - Middle Name:
Authorized Official - Last Name:RASHID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-586-4111
Mailing Address - Street 1:25050 OUTER DR
Mailing Address - Street 2:SUITE 204
Mailing Address - City:LINCOLN PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48146-1297
Mailing Address - Country:US
Mailing Address - Phone:313-586-4111
Mailing Address - Fax:313-556-2225
Practice Address - Street 1:25050 OUTER DR
Practice Address - Street 2:SUITE 204
Practice Address - City:LINCOLN PARK
Practice Address - State:MI
Practice Address - Zip Code:48146-1297
Practice Address - Country:US
Practice Address - Phone:313-586-4111
Practice Address - Fax:313-556-2225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-31
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
239245Medicare Oscar/Certification