Provider Demographics
NPI:1922451897
Name:MICHIGAN HOME CARE AGENCY
Entity Type:Organization
Organization Name:MICHIGAN HOME CARE AGENCY
Other - Org Name:OPEN ARMS HOME CARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:GOFF
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:269-759-3084
Mailing Address - Street 1:1852 COMMONWEALTH ROAD
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH TOWNSHIP CHRTR
Mailing Address - State:MI
Mailing Address - Zip Code:49085
Mailing Address - Country:US
Mailing Address - Phone:269-759-3048
Mailing Address - Fax:269-222-2689
Practice Address - Street 1:1852 COMMONWEALTH ROAD
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH TOWNSHIP CHRTR
Practice Address - State:MI
Practice Address - Zip Code:49085
Practice Address - Country:US
Practice Address - Phone:269-759-3048
Practice Address - Fax:269-222-2689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-15
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health