Provider Demographics
NPI:1881141489
Name:EXPERIENCED HANDS HOMECARE SERVICE
Entity type:Organization
Organization Name:EXPERIENCED HANDS HOMECARE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:LUBINGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-905-1674
Mailing Address - Street 1:16000 W 9 MILE RD STE 523
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-4808
Mailing Address - Country:US
Mailing Address - Phone:248-905-1674
Mailing Address - Fax:
Practice Address - Street 1:16000 W 9 MILE RD STE 523
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-4808
Practice Address - Country:US
Practice Address - Phone:248-905-1674
Practice Address - Fax:947-282-6985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI8026722Medicaid