Provider Demographics
NPI:1700325156
Name:GREAT CARE HOME SERVICES
Entity Type:Organization
Organization Name:GREAT CARE HOME SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADESUWA
Authorized Official - Middle Name:C
Authorized Official - Last Name:AWAYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-758-4826
Mailing Address - Street 1:7059 TIMBERVIEW TRL
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-3353
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7059 TIMBERVIEW TRL
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-3353
Practice Address - Country:US
Practice Address - Phone:248-758-4826
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-17
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care