Provider Demographics
NPI:1952058489
Name:PERSONALIZE HOME CARE SERVICES, LLC.
Entity Type:Organization
Organization Name:PERSONALIZE HOME CARE SERVICES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARLON
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:BURT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-621-1111
Mailing Address - Street 1:28021 SOUTHFIELD RD STE 200
Mailing Address - Street 2:
Mailing Address - City:LATHRUP VILLAGE
Mailing Address - State:MI
Mailing Address - Zip Code:48076-2816
Mailing Address - Country:US
Mailing Address - Phone:248-621-1111
Mailing Address - Fax:
Practice Address - Street 1:28021 SOUTHFIELD RD STE 200
Practice Address - Street 2:
Practice Address - City:LATHRUP VILLAGE
Practice Address - State:MI
Practice Address - Zip Code:48076-2816
Practice Address - Country:US
Practice Address - Phone:248-621-1111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-04
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based