Provider Demographics
NPI:1922129972
Name:EASTWEST TECHNOLOGIES, LLC
Entity Type:Organization
Organization Name:EASTWEST TECHNOLOGIES, LLC
Other - Org Name:EASTWEST HEALTH SERVICES, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:ROA
Authorized Official - Last Name:ESPERE
Authorized Official - Suffix:IV
Authorized Official - Credentials:RPT
Authorized Official - Phone:586-489-4638
Mailing Address - Street 1:35452 MUSTANG DR
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48312-4067
Mailing Address - Country:US
Mailing Address - Phone:586-582-9690
Mailing Address - Fax:586-582-9590
Practice Address - Street 1:31201 CHICAGO RD S
Practice Address - Street 2:SUITE B302
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093-5527
Practice Address - Country:US
Practice Address - Phone:586-582-9690
Practice Address - Fax:586-582-9590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI383512826251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI23-7621Medicare ID - Type UnspecifiedHOME HEALTH AGENCY