Provider Demographics
NPI:1457809774
Name:123 HOME HELP CARE
Entity Type:Organization
Organization Name:123 HOME HELP CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:
Authorized Official - First Name:URSULA
Authorized Official - Middle Name:CHRISTINA
Authorized Official - Last Name:RIOUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-694-1124
Mailing Address - Street 1:25050 MIDLAND
Mailing Address - Street 2:
Mailing Address - City:REDFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48239-3661
Mailing Address - Country:US
Mailing Address - Phone:313-694-1124
Mailing Address - Fax:
Practice Address - Street 1:25050 MIDLAND
Practice Address - Street 2:
Practice Address - City:REDFORD
Practice Address - State:MI
Practice Address - Zip Code:48239-3661
Practice Address - Country:US
Practice Address - Phone:313-694-1124
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care