Provider Demographics
NPI:1336902790
Name:ROO HOME CARE LLC
Entity Type:Organization
Organization Name:ROO HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:BROOKS
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:BUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-474-2688
Mailing Address - Street 1:1420 WASHINGTON BLVD STE 301
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48226-1750
Mailing Address - Country:US
Mailing Address - Phone:317-474-2688
Mailing Address - Fax:
Practice Address - Street 1:1420 WASHINGTON BLVD STE 301
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48226-1750
Practice Address - Country:US
Practice Address - Phone:317-474-2688
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROO HOME CARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-01-30
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care