Provider Demographics
NPI:1326286329
Name:PRINCIPAL HOME HEALTHCARE,LLC
Entity type:Organization
Organization Name:PRINCIPAL HOME HEALTHCARE,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:AYHEM
Authorized Official - Middle Name:
Authorized Official - Last Name:HAWASLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-522-6721
Mailing Address - Street 1:33469 W 14 MILE RD STE 150
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48331-1521
Mailing Address - Country:US
Mailing Address - Phone:248-522-6721
Mailing Address - Fax:248-522-2591
Practice Address - Street 1:33469 W 14 MILE RD STE 150
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48331-1521
Practice Address - Country:US
Practice Address - Phone:248-522-6721
Practice Address - Fax:248-522-2591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-29
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health