Provider Demographics
NPI:1356586531
Name:UNIVERSALL HOME HEALTH CARE, LLC.,
Entity type:Organization
Organization Name:UNIVERSALL HOME HEALTH CARE, LLC.,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH NASH
Authorized Official - Middle Name:G
Authorized Official - Last Name:NASH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-872-3352
Mailing Address - Street 1:1210 PHOENIX ST
Mailing Address - Street 2:SUITE 6
Mailing Address - City:SOUTH HAVEN
Mailing Address - State:MI
Mailing Address - Zip Code:49090-7913
Mailing Address - Country:US
Mailing Address - Phone:269-872-3352
Mailing Address - Fax:269-872-3357
Practice Address - Street 1:1210 PHOENIX ST
Practice Address - Street 2:SUITE 6
Practice Address - City:SOUTH HAVEN
Practice Address - State:MI
Practice Address - Zip Code:49090-7913
Practice Address - Country:US
Practice Address - Phone:269-872-3352
Practice Address - Fax:269-872-3357
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSALL HOME HEALTHCARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-12-02
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIE0836C251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health