Provider Demographics
NPI:1780269423
Name:ISSERCARE, LLC
Entity type:Organization
Organization Name:ISSERCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:OLEG
Authorized Official - Middle Name:
Authorized Official - Last Name:ISSERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-207-3186
Mailing Address - Street 1:7077 FIELDCREST DR STE 100A
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48116-8553
Mailing Address - Country:US
Mailing Address - Phone:810-224-5800
Mailing Address - Fax:
Practice Address - Street 1:7077 FIELDCREST DR STE 100A
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48116-8553
Practice Address - Country:US
Practice Address - Phone:810-224-5800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-15
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health