Provider Demographics
NPI:1740309277
Name:HEALTH LINE HOME CARE, INC
Entity type:Organization
Organization Name:HEALTH LINE HOME CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GHULAM
Authorized Official - Middle Name:
Authorized Official - Last Name:UDDIN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:313-277-4002
Mailing Address - Street 1:1711 MONROE ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-2914
Mailing Address - Country:US
Mailing Address - Phone:313-277-4002
Mailing Address - Fax:313-561-4004
Practice Address - Street 1:1711 MONROE ST
Practice Address - Street 2:SUITE A
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-2914
Practice Address - Country:US
Practice Address - Phone:313-277-4002
Practice Address - Fax:313-561-4004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI237631Medicare ID - Type Unspecified