Provider Demographics
NPI:1215744388
Name:HARVEST HOME CARE AGENCY LC
Entity type:Organization
Organization Name:HARVEST HOME CARE AGENCY LC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELLANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KNOX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-298-9215
Mailing Address - Street 1:851 WENDOVER BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTON SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:49441-5053
Mailing Address - Country:US
Mailing Address - Phone:248-298-9215
Mailing Address - Fax:
Practice Address - Street 1:851 WENDOVER BLVD
Practice Address - Street 2:
Practice Address - City:NORTON SHORES
Practice Address - State:MI
Practice Address - Zip Code:49441-5053
Practice Address - Country:US
Practice Address - Phone:248-298-9215
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-12
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health