Provider Demographics
NPI:1922014760
Name:LIFELINK HOME HEALTH CARE SERVICES, INC.
Entity Type:Organization
Organization Name:LIFELINK HOME HEALTH CARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOYDEB
Authorized Official - Middle Name:
Authorized Official - Last Name:BOSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-702-0890
Mailing Address - Street 1:30300 NORTHWESTERN HWY STE 121
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-3217
Mailing Address - Country:US
Mailing Address - Phone:248-702-0890
Mailing Address - Fax:248-702-0891
Practice Address - Street 1:30300 NORTHWESTERN HWY STE 121
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-3217
Practice Address - Country:US
Practice Address - Phone:248-702-0890
Practice Address - Fax:248-702-0891
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI237506251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI237506Medicare Oscar/Certification