Provider Demographics
NPI:1336706712
Name:BARBARA CARING HANDS AGENCY
Entity Type:Organization
Organization Name:BARBARA CARING HANDS AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR AND OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JERMAINE
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:BERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-237-7531
Mailing Address - Street 1:21170 WINCHESTER ST
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-5675
Mailing Address - Country:US
Mailing Address - Phone:734-237-7531
Mailing Address - Fax:
Practice Address - Street 1:21170 WINCHESTER ST
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-5675
Practice Address - Country:US
Practice Address - Phone:734-237-7531
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-21
Last Update Date:2019-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIB600403067313OtherB600403067313