Provider Demographics
NPI:1932197217
Name:PRIMARY CHOICE HOME CARE OF MICHIGAN, LLC.
Entity Type:Organization
Organization Name:PRIMARY CHOICE HOME CARE OF MICHIGAN, LLC.
Other - Org Name:NEW HORIZONS HOME CARE, LLC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:T
Authorized Official - Last Name:STREBEL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:248-473-5400
Mailing Address - Street 1:32985 HAMILTON CT
Mailing Address - Street 2:SUITE 216
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-3317
Mailing Address - Country:US
Mailing Address - Phone:248-473-5400
Mailing Address - Fax:248-473-3926
Practice Address - Street 1:32985 HAMILTON CT
Practice Address - Street 2:SUITE 216
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-3317
Practice Address - Country:US
Practice Address - Phone:248-473-5400
Practice Address - Fax:248-473-3926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-11
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIB46-28F251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI237567Medicare ID - Type UnspecifiedPROVIDER NUMBER