Provider Demographics
NPI:1285456418
Name:HARLEYS HART HOME HEALTHCARE LLC
Entity type:Organization
Organization Name:HARLEYS HART HOME HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TATIANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:TYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-929-2930
Mailing Address - Street 1:25535 CATALINA ST
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-1774
Mailing Address - Country:US
Mailing Address - Phone:248-929-2930
Mailing Address - Fax:
Practice Address - Street 1:17520 W 12 MILE RD STE 109
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-1907
Practice Address - Country:US
Practice Address - Phone:248-929-2930
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-29
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care