Provider Demographics
NPI:1932635901
Name:MAJESTIC HOME CARE LLC
Entity Type:Organization
Organization Name:MAJESTIC HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:UCHE
Authorized Official - Middle Name:
Authorized Official - Last Name:KANU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-767-8367
Mailing Address - Street 1:24450 EVERGREEN RD STE 102
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-5585
Mailing Address - Country:US
Mailing Address - Phone:248-395-5269
Mailing Address - Fax:
Practice Address - Street 1:24450 EVERGREEN RD STE 102
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-5585
Practice Address - Country:US
Practice Address - Phone:248-395-5269
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI8198978Medicaid