Provider Demographics
NPI:1013773795
Name:MARS HOME ASSISTANCE LLC
Entity Type:Organization
Organization Name:MARS HOME ASSISTANCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AHMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:TANANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-799-4775
Mailing Address - Street 1:4005 ROGER AVE
Mailing Address - Street 2:
Mailing Address - City:ALLEN PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48101-3059
Mailing Address - Country:US
Mailing Address - Phone:137-994-7753
Mailing Address - Fax:
Practice Address - Street 1:4005 ROGER AVE
Practice Address - Street 2:
Practice Address - City:ALLEN PARK
Practice Address - State:MI
Practice Address - Zip Code:48101-3059
Practice Address - Country:US
Practice Address - Phone:137-994-7753
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-21
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care