Provider Demographics
NPI:1811655137
Name:IMMANUEL HOME HELP CARE AGENCY LLC
Entity type:Organization
Organization Name:IMMANUEL HOME HELP CARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/MANAGING EMPLOYER
Authorized Official - Prefix:
Authorized Official - First Name:SHERON
Authorized Official - Middle Name:
Authorized Official - Last Name:SALMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MPHA, BBA
Authorized Official - Phone:734-262-1997
Mailing Address - Street 1:PO BOX 4
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:MI
Mailing Address - Zip Code:48184-0004
Mailing Address - Country:US
Mailing Address - Phone:172-426-2199
Mailing Address - Fax:313-397-2900
Practice Address - Street 1:13854 LAKESIDE CIR FL 2
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48313-1443
Practice Address - Country:US
Practice Address - Phone:734-262-2199
Practice Address - Fax:313-397-2900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-03
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health