Provider Demographics
NPI:1922756063
Name:CLK HOME CARE LLC
Entity Type:Organization
Organization Name:CLK HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED AGENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:A
Authorized Official - Last Name:TROMBETTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-308-3970
Mailing Address - Street 1:47705 WEST RD STE B-102
Mailing Address - Street 2:
Mailing Address - City:WIXOM
Mailing Address - State:MI
Mailing Address - Zip Code:48393-4738
Mailing Address - Country:US
Mailing Address - Phone:248-308-3970
Mailing Address - Fax:248-924-2416
Practice Address - Street 1:34214 OLD TIMBER RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48331-1530
Practice Address - Country:US
Practice Address - Phone:248-308-3970
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-17
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health