Provider Demographics
NPI:1194906776
Name:FINE HOME HEALTH CARE, LLC.
Entity type:Organization
Organization Name:FINE HOME HEALTH CARE, LLC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GASSO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-328-2939
Mailing Address - Street 1:33060 NORTHWESTERN HWY STE 210
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-3695
Mailing Address - Country:US
Mailing Address - Phone:248-328-2939
Mailing Address - Fax:248-328-2941
Practice Address - Street 1:33060 NORTHWESTERN HWY STE 210
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-3695
Practice Address - Country:US
Practice Address - Phone:248-328-2939
Practice Address - Fax:248-328-2941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-24
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI239272Medicare Oscar/Certification