Provider Demographics
NPI:1649405374
Name:INTERDEPENDENCE HOME HEALTH CARE
Entity type:Organization
Organization Name:INTERDEPENDENCE HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAJDEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-332-1903
Mailing Address - Street 1:780 W LAKE LANSING RD STE 780
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-8474
Mailing Address - Country:US
Mailing Address - Phone:517-332-1903
Mailing Address - Fax:517-332-1992
Practice Address - Street 1:780 W LAKE LANSING RD STE 780
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-8474
Practice Address - Country:US
Practice Address - Phone:517-332-1903
Practice Address - Fax:517-332-1992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-26
Last Update Date:2009-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health