Provider Demographics
NPI:1669750253
Name:NU-WAVE HOME HEALTH CARE, INC
Entity type:Organization
Organization Name:NU-WAVE HOME HEALTH CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:OSMANY
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDRADES VALDES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-956-3211
Mailing Address - Street 1:32540 SCHOOLCRAFT RD
Mailing Address - Street 2:SUITE # 230
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-4305
Mailing Address - Country:US
Mailing Address - Phone:734-956-3211
Mailing Address - Fax:734-956-3212
Practice Address - Street 1:32540 SCHOOLCRAFT RD
Practice Address - Street 2:SUITE # 230
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150-4305
Practice Address - Country:US
Practice Address - Phone:734-956-3211
Practice Address - Fax:734-956-3212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-29
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI03696U251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI23-9268OtherCMS CERTIFICATION NUMBER (CCN)