Provider Demographics
NPI:1013139302
Name:HEALTH PRODUCERS HOME CARE AGENCY, INC.
Entity Type:Organization
Organization Name:HEALTH PRODUCERS HOME CARE AGENCY, INC.
Other - Org Name:SIERRA PRIDE HOME HEALTHCARE AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR/DON
Authorized Official - Prefix:
Authorized Official - First Name:BRIDGET
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMED
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:586-576-1930
Mailing Address - Street 1:3456 E 12 MILE RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48092-2511
Mailing Address - Country:US
Mailing Address - Phone:586-576-1930
Mailing Address - Fax:586-576-1932
Practice Address - Street 1:3456 E 12 MILE RD
Practice Address - Street 2:SUITE 1
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48092-2511
Practice Address - Country:US
Practice Address - Phone:586-576-1930
Practice Address - Fax:586-576-1932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI251E00000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI7945605Medicaid