Provider Demographics
NPI:1104162833
Name:HOMESTEAD HOME HEALTH CARE, LLC
Entity type:Organization
Organization Name:HOMESTEAD HOME HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMCOX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-735-1020
Mailing Address - Street 1:21800 HAGGERTY ROAD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:NORTHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48167
Mailing Address - Country:US
Mailing Address - Phone:248-735-1020
Mailing Address - Fax:248-735-1010
Practice Address - Street 1:32001 CHERRY HILL RD
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48186-7902
Practice Address - Country:US
Practice Address - Phone:734-762-8757
Practice Address - Fax:734-762-8945
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-28
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility