Provider Demographics
NPI:1952965774
Name:SOLACE HEART HOME HEALTHCARE
Entity Type:Organization
Organization Name:SOLACE HEART HOME HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHANEA
Authorized Official - Middle Name:
Authorized Official - Last Name:BIBBS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-353-2132
Mailing Address - Street 1:21525 DOEPFER RD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48091-4630
Mailing Address - Country:US
Mailing Address - Phone:313-353-2132
Mailing Address - Fax:
Practice Address - Street 1:21525 DOEPFER RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48091-4630
Practice Address - Country:US
Practice Address - Phone:313-353-2132
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-26
Last Update Date:2019-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health