Provider Demographics
NPI:1932566940
Name:SYNCERE HEARTS HOME HEALTHCARE, LLC
Entity Type:Organization
Organization Name:SYNCERE HEARTS HOME HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:TAMEKA
Authorized Official - Middle Name:S
Authorized Official - Last Name:GRAYS
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:248-242-2847
Mailing Address - Street 1:PO BOX 1772
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48347-1772
Mailing Address - Country:US
Mailing Address - Phone:248-242-2847
Mailing Address - Fax:248-605-8561
Practice Address - Street 1:5836 NORTH MARSHBANK LANE APT203
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:MI
Practice Address - Zip Code:48346
Practice Address - Country:US
Practice Address - Phone:248-242-2847
Practice Address - Fax:248-605-8561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-21
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI7765653Medicaid