Provider Demographics
NPI:1306330246
Name:HARPER'S CARE CLUB, LLC
Entity type:Organization
Organization Name:HARPER'S CARE CLUB, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JASMINE
Authorized Official - Middle Name:ALEXIS
Authorized Official - Last Name:SEAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-404-3134
Mailing Address - Street 1:PO BOX 4835
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48204-0835
Mailing Address - Country:US
Mailing Address - Phone:248-274-6708
Mailing Address - Fax:
Practice Address - Street 1:1732 W BETHUNE ST APT 4
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48206
Practice Address - Country:US
Practice Address - Phone:248-274-6708
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-14
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI8577497Medicaid