Provider Demographics
NPI:1700573623
Name:TAKE CARE HOME HEALTH CARE LLC
Entity Type:Organization
Organization Name:TAKE CARE HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:OMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:ATCHO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-770-9926
Mailing Address - Street 1:18540 W 9 MILE RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-4023
Mailing Address - Country:US
Mailing Address - Phone:248-770-9926
Mailing Address - Fax:
Practice Address - Street 1:18540 W 9 MILE RD
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-4023
Practice Address - Country:US
Practice Address - Phone:888-404-2668
Practice Address - Fax:248-565-9063
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-20
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI9572932Medicaid