Provider Demographics
NPI:1669244711
Name:RELIANCE MANAGEMENT GROUP
Entity type:Organization
Organization Name:RELIANCE MANAGEMENT GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKISSIC
Authorized Official - Suffix:
Authorized Official - Credentials:HOME HEALTH AIDE
Authorized Official - Phone:517-377-6844
Mailing Address - Street 1:1630 W KALAMAZOO ST
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48915-1140
Mailing Address - Country:US
Mailing Address - Phone:517-377-6844
Mailing Address - Fax:
Practice Address - Street 1:1182 W EDGEWOOD BLVD
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48911-7506
Practice Address - Country:US
Practice Address - Phone:517-885-8987
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No172A00000XOther Service ProvidersDriverGroup - Multi-Specialty