Provider Demographics
NPI:1801872841
Name:CONCEPT ONE HOME HEALTH CARE INC
Entity type:Organization
Organization Name:CONCEPT ONE HOME HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:AMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:FEERASTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-887-9470
Mailing Address - Street 1:30700 TELEGRAPH ROAD
Mailing Address - Street 2:SUITE 3636
Mailing Address - City:BINGHAM FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48025-5802
Mailing Address - Country:US
Mailing Address - Phone:248-905-5478
Mailing Address - Fax:248-905-5481
Practice Address - Street 1:30700 TELEGRAPH ROAD
Practice Address - Street 2:SUITE 3636
Practice Address - City:BINGHAM FARMS
Practice Address - State:MI
Practice Address - Zip Code:48025-5802
Practice Address - Country:US
Practice Address - Phone:248-905-5478
Practice Address - Fax:248-905-5481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-21
Last Update Date:2014-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI237521251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI237521Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER