Provider Demographics
NPI:1336819804
Name:MIAS HOME CARE LLC
Entity type:Organization
Organization Name:MIAS HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:THWENI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-333-0005
Mailing Address - Street 1:31513 NORTHWESTERN HWY
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-2528
Mailing Address - Country:US
Mailing Address - Phone:248-333-0005
Mailing Address - Fax:
Practice Address - Street 1:31513 NORTHWESTERN HWY
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-2528
Practice Address - Country:US
Practice Address - Phone:248-333-0005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-16
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health