Provider Demographics
NPI:1104452143
Name:OBIOMA CARE HOME HEALTH AGENCY
Entity type:Organization
Organization Name:OBIOMA CARE HOME HEALTH AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ODINAKA
Authorized Official - Middle Name:OSCAR
Authorized Official - Last Name:DURU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-390-3632
Mailing Address - Street 1:26847 GRAND RIVER AVE STE 7
Mailing Address - Street 2:
Mailing Address - City:REDFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48240-1544
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:26847 GRAND RIVER AVE STE 7
Practice Address - Street 2:
Practice Address - City:REDFORD
Practice Address - State:MI
Practice Address - Zip Code:48240-1544
Practice Address - Country:US
Practice Address - Phone:248-390-3632
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-22
Last Update Date:2020-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty