Provider Demographics
NPI:1952721532
Name:DOMESTIC HOME HELP CARE SERVICE
Entity Type:Organization
Organization Name:DOMESTIC HOME HELP CARE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:313-345-9950
Mailing Address - Street 1:16147 MEYERS RD
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48235-4108
Mailing Address - Country:US
Mailing Address - Phone:313-345-9950
Mailing Address - Fax:313-345-9952
Practice Address - Street 1:16147 MEYERS RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48235-4108
Practice Address - Country:US
Practice Address - Phone:313-345-9950
Practice Address - Fax:313-345-9952
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-22
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0049062Medicaid