Provider Demographics
NPI:1124057815
Name:OLYMPIA HOME CARE, INC
Entity type:Organization
Organization Name:OLYMPIA HOME CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MWABA
Authorized Official - Middle Name:
Authorized Official - Last Name:MWENYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-684-0739
Mailing Address - Street 1:210 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:MI
Mailing Address - Zip Code:49120-2304
Mailing Address - Country:US
Mailing Address - Phone:269-684-0739
Mailing Address - Fax:269-687-1001
Practice Address - Street 1:210 E MAIN ST
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:MI
Practice Address - Zip Code:49120-2304
Practice Address - Country:US
Practice Address - Phone:269-684-0739
Practice Address - Fax:269-687-1001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health