Provider Demographics
NPI:1649225244
Name:RESIDENTIAL HOME CARE INC
Entity type:Organization
Organization Name:RESIDENTIAL HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:E
Authorized Official - Middle Name:G
Authorized Official - Last Name:METROPOULOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:586-751-0200
Mailing Address - Street 1:11477 EAST 12 MILE ROAD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48093-2678
Mailing Address - Country:US
Mailing Address - Phone:586-751-0200
Mailing Address - Fax:586-751-0414
Practice Address - Street 1:11477 EAST 12 MILE ROAD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093-2678
Practice Address - Country:US
Practice Address - Phone:586-751-0200
Practice Address - Fax:586-751-0414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
E06455OtherBCBSM
E06455OtherBCBSM